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Medicare and Medicaid in the U.S.

Include information such as but not limited to the following:

purpose of the program
benefits of the program
procedure to submit a claim for each program

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Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is jointly funded by the state and federal governments and is managed by the states. It provides helath insurance coverage to certain categories of low-income individuals, including children, pregnant women, parents of eligible children, and people with disabilities. Medicaid was created to help low-income individuals who fall into one of these eligibility categories. Medicare helps eligble individuals with little or no medical insurance. There are several Medicaid eligibility categories: within each category there are requirements other than income that need to be met. These requirements can include, age, pregnancy, disability, income, and resources and status as an American citizen or legal immigrant. Achild may be covered under Medicaid if he/she is U.S. citizen or a permanent resident. Medicaid provides the largest portion of federal money spent on health care for people living with HIV/AIDS. More than half of people living with AIDS in the U.S. are estimated to receive Medicaid payments. Two other programs that provide financial assistance to people living with AIDS/HIV are the Social Security Disability Insurance and the Supplemental Security Income. Medicaid does not pay benefits ot individuals directly. It sends benefit payments to helath care providers. In soem statesd beneficiaries are required to pay a small fee for medical services.

Some states have incorporated the use of private companies to administer portions of Medicaid benefits, refered to a Medicaid managed care. The programs allow private insurance companies or HMO's to contact directly with a state Medicaid department at a fixed price per enrollee. The health plans then enroll eligible individuals into their ...

Solution Summary

The following solution gives some basic information about the Medicare and Medicaid programs in the U.S.