(Closed) Can someone explain Medicare/Medicaid?

posted 6 years ago in Wellness
Post # 3
87 posts
Worker bee
  • Wedding: January 2013

Basically Medicare is for individuals over 65 and Medicade is for low income people and families.

There is actually a LOT more to say about it, but its probably more than you want to read haha, you don’t want to sit in front of your computer for hours reading about it.


This is a pretty detailed chart. 🙂

Post # 4
87 posts
Worker bee
  • Wedding: January 2013

I hope that helped!! YAY for informed voters. I really excited when people vote based on issues and policies rather than voting by the party they are affiliated with!


Post # 5
5547 posts
Bee Keeper
  • Wedding: December 2011

That chart is pretty great actually. I’m a nurse and it still confuses me sometimes!

Medicare is also what pays for permently disabled people’s health care. Like, in the state hospital (moderate to profound mental and physical diabilities) like 98% of the patients are medicare paid, usually people with private insurance with those same conditions are in private residential treatment centers.  For a huge percent of renal dialysis patients who can’t get or can’t afford private insurance, medicare covers the dialysis and associated medications reguardless of compliance or previous conditions. Interestingly we were discussing this in my community health class yesterday, and soon there is going to have to be a shift in how this stuff works, when it started, especially medicare, people lived to be 68-70 not 85-100 so the amount of money required just due to life exspectancy has increased, and the cost of medical services is getting insane, but at the same time, there are only so many ways to cut cost before things aren’t safe.

My dad is a dialysis patient due to a genetic disease that has killed his kidney fuction. It is a very good thing my mom works at a company with incredible group insurance (he is currently 100% disabled and unable to work) because patients at his same clinic without the insurance (and thus, on medicare usually) have limits on stuff even like how much medical tape they can use each treatment, or how much Medicare reimburces the clinic for at least. 

Medicade is used by a lot of lower income families, especially for stuff like child birth which is so ungodly expensive, but you can’t really NOT go to the docter for it. Medicade, at least in Texas is the same area that CHIP, or low cost insurance for school aged kids comes from. 

The major issues that come from both these systems is that there is almost NO allowance for preventative medicine, it is almost totally reactive, so, for example, it is much easier to get coverage for the hospital stay AFTER you have a heart attack than for the screenings and medications you need to prevent it. Or at least that is how my profs explained it.  It is bad because usually, preventative healthcare is much cheaper than reactive healthcare. 

Post # 6
4419 posts
Honey bee
  • Wedding: December 2010

Medicaid is not only for low income families.  It also helps a lot of seniors who are in nursing homes. A lot of times, seniors cannot afford to pay to live in a nursing home, but they need the constant care they are given in one.  Medicaid picks of the costs of the nursing home, and their medicare takes care of their health care.

An easy way to remember which is which is MediCARE provides healthCARE to seniors and disabled people. It is not an entitlement, but rather a benefit they contributed into during their years of employment.

MedicAID provides AID to lower income families and seniors who need assistance for living expenses that they cannot afford do to their financial situations. This is not a program they contributed, but rather a safety net to help needy families get on their feet. People on medicaid are required to look for work in order to continue receiving aid. Seniors in nursing homes are exempt from that requirement, but seniors are required to exhaust all other means of income before Medicaid will assist them. 

Insurance companies make big bucks off seniors by selling them Medicare suppliment policies and long term care policies. These policies help cover expenses that are not covered by Medicare or Medicaid.  

It is, of course, much more complicated than that, but that scratches the surface of the basics. 

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