Medicare and Medicaid

Part A (Hospital insurance)

Covers:

• inpatient hospital care

• skilled nursing facilities care

• home healthcare

• hospice care

Part B (Supplementary medical insurance)

Coverage:

• physicians’ services

• outpatient hospital care

• other medical services (e.g. many preventive services: mammography, colorectal cancer screening)

Part C (Medicare advantage)

This is an alternative way for Medicare beneficiaries to receive their Medicare benefits.

Part D (Prescription drug benefit)

Coverage for prescription drugs

Part A (Hospital insurance)

No premium if meeting certain criteria (e.g. self or spouse worked for at least 10 years while paying Medicare taxes); If people do not meet the criteria, they can purchase (this part) by paying a monthly premium

Part B (Supplementary medical insurance)

Everyone needs to pay a monthly premium

Part C (Medicare advantage)

Instead of enrolling in the traditional Medicare programs, (this part) beneficiaries can choose to receive their Medicare benefits through a private health insurance plan approved by Medicare.

Medicare (for):

Health insurance for:

1. those aged 65 or older

2. those aged under 65 with certain disabilities

3. those of any age with end-stage renal disease

Medicaid (for):

Health insurance for individuals who:

1. meet both financial and non-financial criteria

2. pregnant women with limited income

3. children and teenagers with limited income

4. those aged, blind, and/or disabled with limited income

Mandatory services that Medicaid must provide:

1. Inpatient hospital services

2. outpatient hospital services

3. physician services

4. rural health clinical services

5. immunization and other preventive services for children

6. family planning services

7. nurse midwife and nurse practitioner services

Optional services for Medicaid:

1. Prescription drugs

2. dental and vision care

3. institutional care for individuals with intellectual disabilities

4. home and community-based care for the frail elderly

5. personal care and other community-based services for individuals with disabilities

Medicare (description):

social insurance policy for those who have paid through taxes

Medicaid (description):

redistributing wealth among U.S. citizens