Medicaid vs. Medicare
The United States federal government provides Medicare and Medicaid health insurance programs. Medicare covers people over 65 and those with disabilities who meet certain eligibility requirements. Medicaid provides assistance to individuals who meet certain income requirements, making up a large portion of the federal budget. We will examine each of these programs in detail in the following sections.
Medicare: what is it?
Medicare, created under the presidency of Lyndon B. Johnson in 1965, provides health insurance to individuals over the age of 65 and those with disabilities who meet specific income and medical requirements. Typically, private health insurance companies are hesitant to cover individuals in this age group due to the likelihood of expensive medical conditions. The federal government implemented Medicare to address this issue and expand the social safety net established by Franklin Delano Roosevelt’s New Deal programs during the Great Depression in the 1930s.
Social Security was a much larger program than Medicare that began in 1935. Medicare is an additional benefit provided under the umbrella of the Social Security program. It is available to people over 62 and certain people with disabilities. Social Security started in 1935 and provides a retirement income to people over 62.
In addition to providing high-quality health insurance to people without pre-existing conditions or income restrictions, Medicare covers most programs without requiring a monthly premium. This makes Medicare accessible to everyone. In other words, when Americans pay their taxes each year, they pay for their future Social Security and Medicare benefits. Medicare is funded by taxes levied on income.
Medicare has generally been a very popular program, supported by both Democrats and Republicans. However, due to its high cost, there have been calls for reform.
Is Medicare available to everyone?
The Medicare program is available for those aged 65 or older who are legal residents of the United States. Additionally, individuals under the age of 65 with severe disabilities may also be eligible. However, proper documentation from healthcare providers is necessary to qualify for Medicare in this circumstance. It should be noted that not all disabilities automatically make someone eligible for Medicare and most people with disabilities must first be enrolled in Medicaid before being able to apply for Medicare after two years. Certain conditions, like end-stage kidney disease, may immediately qualify someone for Medicare coverage.
Medicare’s parts
There are four parts to Medicare coverage:
- Part A covers inpatient procedures, such as surgery, in a hospital. As well as nursing homes, home care and lab tests. Part A is one of the most important parts of Medicare because it covers treatments that are extremely expensive in the long run. It is especially true for elderly people who have to stay in nursing homes or similar long-term care facilities for their last years.
- Part B covers outpatient services including x-rays, colonoscopies, ultrasounds, ambulance care, and medical equipment.
- Part C allows patients to purchase supplemental private coverage from a health insurance company that is approved by the federal government to offer Medicare coverage. This gives people on Medicare access to higher-quality services that may not be offered under Parts A and B. Many of the services provided by Part C involve copays. Most people do not want to enroll in Part C. Parts A and B are mandatory; Part C is not.
- Part D was created in 2003 after years of intense lobbying. It covers prescription drugs. Part D is the newest part of Medicare. A prescription drug component was added to Medicare because prescription drugs were becoming so costly that it was becoming a major burden on seniors to pay for their much-needed medications.
Medicaid: what is it?
Medicaid, a federal health insurance program for low-income individuals, is jointly funded and administered by the federal government and various state governments. Along with Medicare, which was also established in 1965, Medicaid initially only covered low-income families and individuals with specific disabilities. However, the passage of the Affordable Care Act (also known as Obamacare) in 2010 expanded Medicaid eligibility to millions of other Americans.
Medicaid: Who Qualifies?
To be eligible for Medicaid, a person must meet certain criteria. This includes being below the age of 65, as individuals over this age typically receive Medicare instead. Additionally, income plays a significant role in determining eligibility for adults. Their income must be equal to or below 133% of the federal poverty level. Some states may use a slightly different figure of 138%. The specific salary ranges that qualify an individual can vary from year to year. For example, as of 2022, an annual income of $18,075 or less would make someone eligible for Medicaid.
When it comes to families, the