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October 28, 2012

Essay on Medicare and Medicaid


Medicare and Medicaid
Introduction to Medicare and Medicaid
Medicare and Medicaid are the names that are used for the two collective governmental programs that are designed to provide quality health and medical facilities to specific groups of the people of the United States. Despite of the various differences that are found in the eligibility criteria and requirements of the two programs, both of these health and medical programs are managed and supervised by the Centers of Medicare and Medicaid Services, which is a faction of the Health and Human Services Department of the United States. (Allen, 2001)
Dynamics of Medicaid
Medicaid is defined as health and medical services program for people and individuals who do not possess the financial ability and capacity to pay for the massive health budgets due to their low incomes and limitation of resources available. Primary oversight of the program is established at the federal level, but the eligibility benchmarks regarding the program vary from one state to the other. In addition to this the scope of services, rate of payment services and administering of the Medicaid program are some of the other salient features that fluctuates from one state to the other.
A wide and diverse range of services are offered at the disposal of people who are registered in Medicaid programs. These services are provided by the different state funded centers that are established for the fulfillment of these purposes, but the state does need to accomplish some of the compulsory federal requirements and stipulations to access funding from the federal government. (Medical News, 2010)
Once these requirements are satisfied, the Medicaid program will be in a position to provide inpatient and outpatient hospital services to people, prenatal care facilities, vaccination for children, family planning services, rural and urban health care services, convenience for radiology related functions and medical examinations, federally qualified health-center (FQHC) amenity and ambulatory services along with early periodic screening and diagnosis for children under the age of 21.
Apart from all the services mentioned, states may also provide additional health and medical benefits if consistent funding from the federal government is received. These services encompass diagnostic and clinical oriented services, transport services in cases of emergency, home and community based care to people with unremitting impairments along with the application of physical therapeutic services and facilities. Another important area that needs to be highlighted here is the eligibility criteria according to which these services are provided to patients. The criteria designed needs to fulfill the requirements such as age, pregnancy status, citizenship and financial capacity. The state needs to inform the federal government about all these conditions for the acquisition of required funding amount for proper medical and health sustenance of deserving people. (Peltz, 2007)
Dynamics and Differences between Medicare and Medicaid
Unlike Medicaid program which is predominantly related to the provision and access to quality health and medical benefits to people, Medicare is concerned with the health insurance program that is designed to afford the health and medical expenses of hospitals for elderly and disabled people of the country. The Medicare program which consists of two programs A and B deal and provide various conveniences related to the hospital insurance which affords expenses for hospital visits, physical therapies, food meals, medicine supplies and testing whereas program B is primarily concerned with the expenses that are related to doctor expenses in the form of their visits, provision of nursing facility and even the availability of wheelchairs and walkers are compensated in the program.
While program B is based on the monthly premium of $96.40 in 2009, program A of the Medicare program is completely afforded on payroll taxes for the reimbursement of medical expenditures. Differences between the two programs of Medicare and Medicaid are also manifested in the form of eligibility standards of the two programs. The eligibility of Medicare demands that an individual enrolling in the program must be 65 years or above, or as an alternative he must be disabled.
Apart from these two requirements any individual suffering from renal disorders which can only be cured either through dialysis or kidney transplant. In addition to this the fulfillment of the suitability also requires that the individual must be a US based citizen with up to 5 years of legal residence in the country. Like the eligibility criteria, payment methods and affordability procedures of the two programs also vary to a substantial extent.
In contrast to the Medicaid expenses which are accommodated in the form of payment sent to health care providers, expenses relating to Medicare are compensated in the form of payroll taxes that are collected through Federal Institutions Contributions Act (FICA) and the Self-Employment Contributions Act which serve as the primary component that plays a pivotal role in the funding of the medical program.
Additional funding for the entire program also comes from multitude sources which include premiums, coinsurance and copays. Another prominent difference between the two is that unlike Medicaid which cannot accommodate up to 60% of the poor population of the country whereas in that context Medicare is much more influencing and effectual in terms of application and implementation. (Bryan, 2004)





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