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Mark Reckman - Medicare vs. Medicaid
- 2024/08/07
- 再生時間： 9 分
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あらすじ・解説
Medicare and Medicaid are the same thing, right? They come as a package, right? Aren’t they the same?
Well, while they both address medical costs, they are not a package and they are very different.
Back in the 1960s, when JFK was assassinated, he was succeeded by his VP – a Texan named Lynden Johnson. Johnson’s goal was to expand the social “safety net”. He called his program “The Great Society”.
The Great Society had three main pillars:
1) Expanded Social Security.
2) Medicare – this was a new Federal program.
3) Medicaid – this was a new State program funded with federal money.
Medicare is federally subsidized health insurance. It was designed for folks who were otherwise uninsured. It covers everyone over 65 and disabled people of any age. There are no financial conditions – just age and disability. For example, Warren Buffet and Bill Gates are eligible for Medicare.
Medicare covers doctor bills, hospital bills, and, if you elect, prescriptions. It is NOT comprehensive and many folks elect to buy additional coverage (called “gap filler” or Medi-gap policies, etc.) Medicare is pretty cheap – but the premiums are scaled such that higher income folks pay higher monthly premiums.
Premiums are very often deducted from your social security before you get your check.
Medicare is funded and run by the federal government. They often hire private insurance companies to manage the claims and the paperwork.
But, most of all, Medicare is health insurance and only pays for medical care – just like the health insurance you get from your employer.
Medicaid is not the same. It is not health insurance. It is not run by the federal government. Medicaid is a welfare program – run by the state welfare departments. The federal government pays a big chunk of the cost but does not run the program. And, it is for poor folks only – you have to be broke to qualify to receive it. There are no premiums to pay. But, it is not the sort of thing to aspire to have. It’s something you “settle” for if you do not have a better choice.
Initially, Medicaid was designed to pay for nursing home care. Not medical care – just room and board (which is NOT covered by Medicare). Called “custodial care”, it has expanded in many ways over the years and now offers benefits for disabled people living in the community. The purpose is to keep them out of a nursing home because that saves the government money and improves quality of life.
Examples of what Medicaid will pay for now:
Treatment of substance abuse
Private duty nursing
Nursing home room and board
Assisted Care
Vision
Dental
Transportation
Family planning
Prescriptions
Clearly, there is overlap between these programs. And there are folks who are eligible for both. This causes a lot of confusion and that is not going to change anytime soon. So, seek help when you need it. Do NOT rely on what you hear at the hairdresser or the barber shop. Call a Medicare specialist, a Medicaid professional or call Pro Seniors for help.
Well, while they both address medical costs, they are not a package and they are very different.
Back in the 1960s, when JFK was assassinated, he was succeeded by his VP – a Texan named Lynden Johnson. Johnson’s goal was to expand the social “safety net”. He called his program “The Great Society”.
The Great Society had three main pillars:
1) Expanded Social Security.
2) Medicare – this was a new Federal program.
3) Medicaid – this was a new State program funded with federal money.
Medicare is federally subsidized health insurance. It was designed for folks who were otherwise uninsured. It covers everyone over 65 and disabled people of any age. There are no financial conditions – just age and disability. For example, Warren Buffet and Bill Gates are eligible for Medicare.
Medicare covers doctor bills, hospital bills, and, if you elect, prescriptions. It is NOT comprehensive and many folks elect to buy additional coverage (called “gap filler” or Medi-gap policies, etc.) Medicare is pretty cheap – but the premiums are scaled such that higher income folks pay higher monthly premiums.
Premiums are very often deducted from your social security before you get your check.
Medicare is funded and run by the federal government. They often hire private insurance companies to manage the claims and the paperwork.
But, most of all, Medicare is health insurance and only pays for medical care – just like the health insurance you get from your employer.
Medicaid is not the same. It is not health insurance. It is not run by the federal government. Medicaid is a welfare program – run by the state welfare departments. The federal government pays a big chunk of the cost but does not run the program. And, it is for poor folks only – you have to be broke to qualify to receive it. There are no premiums to pay. But, it is not the sort of thing to aspire to have. It’s something you “settle” for if you do not have a better choice.
Initially, Medicaid was designed to pay for nursing home care. Not medical care – just room and board (which is NOT covered by Medicare). Called “custodial care”, it has expanded in many ways over the years and now offers benefits for disabled people living in the community. The purpose is to keep them out of a nursing home because that saves the government money and improves quality of life.
Examples of what Medicaid will pay for now:
Treatment of substance abuse
Private duty nursing
Nursing home room and board
Assisted Care
Vision
Dental
Transportation
Family planning
Prescriptions
Clearly, there is overlap between these programs. And there are folks who are eligible for both. This causes a lot of confusion and that is not going to change anytime soon. So, seek help when you need it. Do NOT rely on what you hear at the hairdresser or the barber shop. Call a Medicare specialist, a Medicaid professional or call Pro Seniors for help.