General Health Programs : Medicare and Medicaid

Medicare Program

The Medicare program provides healthcare coverage for seniors over the age of 65 and many disabled individuals. Since the program was implemented in 1966, the number of Medicare beneficiaries has increased from 19 million to 40 million. By 2030, Medicare is projected cover more than 77 million people. Despite the dramatic growth in the program and continuing advances in medical practice, the Medicare benefit package has changed very little during the past 35 years.

One of the greatest challenges facing the Medicare program is managing the care for the increasing numbers of beneiciaries with chronic illnesses. According to a recent study, health care spending for a person with a single chronic illness is two times greater than spending for those without chronic care needs, while spending for individuals with ive or more chronic conditions is 14 times as great.The profiles in this report illustrate some of the ways that Medicare Advantage plans play an important role in improving care for Medicare beneiciaries. These proiles are only a sample of initiatives that Blue Cross and Blue Shield Plans across the country have adopted to increase the quality of care delivered to Medicare beneiciaries. These initiatives focus on providing preventive care, and implementing programs designed to improve coordination and help beneiciaries manage chronic conditions. Investment in these programs is demonstrating results in terms of improved performance on quality of care and patient satisfaction. As Medicare prepares for a future in which population growth and the increasing incidence of chronic disease will strain the program, continued investment in Medicare Advantage will be critical to ensure that beneiciaries have access to the preventive beneits, coordination and management they need. Because of the tremendous importance of early intervention in treating chronic illnesses, MA plans’ focus on prevention and care coordination and management provides beneiciaries with additional tools to help them manage their health more effectively and avoid preventable complications. For more detailed information about Medicare, offer Medicare Information for frequently ask question.

Medicaid Program

General Medicaid Information have describe at the following statement. You may qualify for Medicaid benefits if you meet any of the following guidelines:

• You are 65 years old or older.
• You are legally blind.
• You are disabled.
• You are in a nursing home.
• You receive hospice care.
• You receive Medicare Part A.
• You receive Supplemental Security Income (SSI).
• You are a refugee who has been in the U.S. for eight months or less.
• You have children under age 18.
• You are pregnant.
• You are 18 years old or younger.
• You are in foster care.

Medicaid can pay for all or a portion of nursing home care if you need Medicaid to pay for nursing home care, your spouse does not have to be impoverished, receiving nursing home care, your spouse may be able to retain some income for living in the community and Medicaid may be able to pay for intermediate nursing care in your home or in an Adult Day Health Care Center.

Medicare or private health insurance will not prevent you from being eligible for Medicaid. If you have medical expenses, you might be eligible for Medicaid regardless of your income. The home in which you live is not counted as a resource and does not affect your eligibility for Medicaid (unless you are institutionalized).