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Understanding Medicaid and Medicare Insurance Coverage

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Medicaid:

  • Medicaid is a program funded by states and the federal government to provide various insurance coverages for low income citizens including families, children, elderly and the disabled.

  • There are income requirements to qualify for Medicaid. Although the government and states fund Medicaid, states generally have authority to establish program rules, therefore Medicaid services and eligibility requirements can vary from state to state.

  • General coverages include: hospital services, physician services, lab and x-rays, home health care and dental for children.

  • The nations Medicaid program has progressively been having serious funding problems due to such problems as rising health care costs and a failing economy, which qualifies more individuals for coverage. To get more Medicaid information you can contact your local social and family services program.

    Medicare:

  • Medicare insurance is the nations largest health insurance program. Medicare coverages include people age 65 and over, disabled persons under 65 and persons with permanent kidney failure.

  • Medicare insurance has two parts: Part A, Hospital Insurance and Part B, Medical Insurance.

  • Part A is usually fully funded for participants over the age of 65 and pays for such services as hospital care, nursing facilities, and hospice. This part of medicare coverage has no premium because as the participant or their spouse was working in their early years, they paid it through Medicare taxes. If Medicare insurance taxes were not paid, one may still be eligible to pay a premium for part A.

  • Part B pays for such Medicare services as physician, outpatient hospital, and therapists that are medically necessary.
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