Medicaid Versus Medicare | Jane Jackson, RN, CRC | RxEconsult

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Medicaid Versus Medicare Category: Healthcare Administration by - October 25, 2016 | Views: 30896 | Likes: 1 | Comment: 0  


Medicaid, a joint federal and state program, serves low-income people of every age.  The federal government funds up to 50% of the cost of each state's Medicaid program, with more affluent states receiving less funding than less affluent states. There are 50 different Medicaid programs, one for each state.  Patients pay no part of costs for covered medical expenses.  

Medicaid has strict eligibility requirements and the rules vary by state.  The program is designed to help the poor thus requiring recipients to have no more than a few thousand dollars in available assets and a qualifying maximum income. 

Services vary by state, but the federal government mandates coverage for the following services when deemed "medically necessary":

  • Hospitalization
  • Laboratory services
  • X-rays
  • Doctor services
  • Family planning
  • Nursing services
  • Medical and surgical dental services
  • Nursing facility services for people aged 21 or older
  • Home health care for people eligible for nursing facility services
  • Clinic treatment
  • Pediatric and family nurse practitioner services
  • Midwife services
  • Screening, diagnosis and treatment services for persons under age 21

Each state also has the option of including additional benefits, such as prescription drug coverage, optometrist services, eyeglasses, medical transportation, physical therapy, prosthetic devices and dental services.

The Bottom Line

The Medicare and Medicaid programs work together to provide medical coverage to elderly and poor people. Medicare is the primary medical coverage provider for many persons aged 65 and older and for those with a disability. Eligibility has nothing to do with income level. Meanwhile, Medicaid eligibility is designed for people with limited income and is often a program of last resort for those without access to other resources.

This is a brief description.  For more information please visit Medicare and Medicaid directly.

About The Author

Jane Jackson has more than  25 years experience in healthcare, including hospital-based care, home health, and managed care. She enjoys sharing her knowledge and can she be reached at Also visit her blog, Daily Dose HQ.

Also Read:

What Is Managed Care?

What Is The 5 Star Rating System For Managed Care? 

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List Of HEDIS 2017 Measures


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