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Medicare and Medicaid

Medicare and Medicaid are two of the most commonly used government health insurance programs. Your boss has asked you to do some research on both programs so the information you compile can be used to help train new hires in your department.

details the basic information on Medicare and Medicaid programs in the United States.

â?¢general overview of the program
â?¢purpose of the program
â?¢eligibility
â?¢benefits of the program
â?¢procedure to submit a claim for each program

Solution Preview

Medicare is a major health insurance program for the elderly and younger people who have certain disabilities, paying about 30% of the medical costs of older Americans. Medicare operates similarly to a single -payer health care system. It provides basic health coverage for acute episodes of illness that require skilled professional care; it also pays for some preventive services. As of 2006, Medicare subscribers could enroll in privately managed prescription drug coverage plans known as Medicare Part D. The Centers for Medicare and Medicaid Services a component of the Department of Health and Human Services administers the two programs as well as the State Health Insurance Program and the Clinical Laboratory Improvement Amendments. Along with the Departments of Labor and Treasury, CMS also implements the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996. The Social Secuirty Admnistration is partially responsible for determining Medicare elgibility and processing payments for the Medicare program. The Medicare program offers residents 65 and older and people with certain disabilities more affordable healthcare options. People under 65 may be eligble if they receive Social Security Disabilty Insurance Benefits. For example younger people may be eligble for benefits if they get dialysis for end stage kidney disease. People with diasibilities who receive SSDI benefits are only eligible for Medicare while they receive SSDI payments.To receive Medicare benefits a person needs to be an American citizen and lived in the country for at least five consecutive years. People who receive benefits need to be 65 and older or have a permanent disability.

Medicare benefits consist of four parts: Parts A, B,C and D. Part A ...

Solution Summary

This solution provides some basic information about Medicare and Medicaid in the U.S.

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