What is the difference between Medicare & Medicaid?

History of Medicare & Medicaid

Medicare started back in 1965 to help older folks and people with disabilities get health insurance from the government. It covers medical costs for those 65 and up, plus younger folks with certain medical conditions like kidney disease or ALS. The government agency in charge is called the Centers for Medicare & Medicaid Services (CMS).

Now, let's talk about Medicaid. It's another government health program, but it's for folks with low incomes. Both the federal government and the states work together to run it. Each state has its own way of doing things based on what their people need. Medicaid helps lots of different groups, like adults and kids with low incomes, pregnant women, older folks, and folks with disabilities. Basically, it's there to help out anyone who needs it across the country.

Medicaid Eligibility and Coverage

Medicaid looks at things like how much money you make and how big your family is to decide if you can get help. But it also looks at other stuff like your age and if you're pregnant. The Affordable Care Act (ACA) made it so more folks with low incomes could qualify for Medicaid in some states. This helps more people get health coverage.

Nowadays, many states use private health insurance companies to help run Medicaid. These companies work with the state to give folks their Medicaid benefits. The goal is to make sure people get the care they need and to keep costs down. This all helps make sure everyone in the country gets better health outcomes.

Medical Billing in Medicare and Medicaid

People who get help from Medicare and Medicaid need to know a lot about the rules and how payments work. That's because healthcare providers have to deal with a lot of rules and processes set by CMS. It's a complicated system, but understanding it well is important for getting bills right, following rules, and getting paid on time. Below, we'll go over important things about billing for medical services through Medicare and Medicaid to help you understand how payments work better. Read More...