Medicaid and Medicare

Medicaid and Medicare Healthcare Programs

The modern world is faced with several health challenges that have been aggravated by the change of lifestyle in the society. The society nowadays no longer involves themselves in body exercises leading to increases in chronic illnesses like cancer in people of all ages (Berkowitz et al, 2018).The high prevalence on illnesses therefore has led to high cost of living due to the huge medical bills incurred. Due to the rise in medical bills, Medicaid and Medicare were introduced to help in the reduction of the burdens brought about by the huge medical bills. 

Medicaid and Medicare programs

Both Medicare and Medicaid programs are the healthcare initiatives developed by the federal government in 1965. Medicaid is state and federal healthcare initiative that provides the patients earning low income with health care coverage (Berkowitz et al, 2018). On the other hand, Medicare is only a federal program providing health care coverage the elderly people who are 65yeras and above as well as people living with disabilities and cannot provide for themselves. However, Medicare does not consider the income of the patients they are covering. 

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Eligibility for Medicare and Medicaid benefits

Medicare eligibility 

Patients under the Medicare program are enrolled in part A and part B when getting healthcare services. the part A of the medic are program only covers inpatient services where patients are admitted for a night and are released upon getting treatment. The part A of the Medicare program also covers the elderly patients at the nursing homes for long durations. Part B on the other hand covers the medical procedures that are not covered under part A including x-rays, nursing care services and the physician services. 

Therefore, for a patient to be eligible to a Medicare program he or she should be 65 years old or above. In addition, a patient must be disabled permanently for a period of more than three years and should be receiving disability benefits from the government. Moreover, patients with end-stage renal disease (ESRD) who are in need of a kidney transplant are automatically enrolled for a Medicare program. Lastly, all patients suffering from any Lou Gehrig’s diseases are eligible for Medicare coverage. 

Medicaid eligibility 

The eligibility to Medicaid services differs with a country but there are the most universal qualifications across all countries. To start, for a patient to get Medicaid coverage, he or she should be a low income earner who cannot afford to pay for his or her medical bills. In addition, to be enrolled with a Medicaid program on has to be a full American citizen (Grabowski, Joyce, McGuire & Frank, 2017).Both elderly and disabled people are automatic beneficiaries of the Medicaid program without any compromise. People battling with chronic illnesses like cancer are also beneficiaries of the Medicaid coverage. Lastly, all people who qualify for the Medicare program are automatically eligible for a Medicaid cover. 

Effects of Medicare on billing 

Medicare has positively affected the billing at the health care facilities making it easy to offer treatment to the patients. Therefore, Medicare caters for the major costs in a hospital thus reducing the burden of medical bills on the patients. First, Medicare caters for all the prescribed drugs available at a health facility at full cost (Danagoulian, Janke & Levy, 2018).  In addition, all the pediatric cost incurred in the hospital is fully settled by the Medicare program. The coats incurred when treating the mentally challenged patients are also paid by the Medicare program in full. Family planning services to both male and female are fully covered under the Medicare program. Additionally, patients undergoing occupational, physical and speech therapies are fully catered for by the Medicare initiative. All the inpatient and patient services are fully waived under the Medicare program to all the eligible patients. Lastly, mouth related problems and dental medical care are fully covered by the Medicare initiative thus reducing bills on patients. 

Impact of ACA on Medicaid and Medicare recipients

The Affordable Care Act (ACA) is a healthcare reform and exhaustive law implemented in 2010 in America. The ACA law is also referred to as the Obamacare since it was introduced during his tenure. The main goal of the introduction of the ACA reform was to ensure that all citizens in America had a health care insurance. In addition, the ACA reform ensured that there was expansion of the Medicaid program to all the health care facilities. Lastly, the ACA reforms introduced health care methods that were innovative and supportive in the reduction of the health care cost. 

However, the ACA reforms had major impacts on Medicaid that positively influenced healthcare thus improving the living standards in the society. To start with, ACA ensured the member of enrolled people was increased by conducting outreach to the society. in addition, all the individuals enrolled with Medicaid were entitled to the state plan benefits as well as being exempted ABP. the ACA reforms ensured all the low income earners were enrolled to the Medicaid initiative without discrimination (Card Dobkin & Maestas, 2018).  The ACA reforms reached out to the American citizens living with disabilities to register with the Medicaid initiative thus reducing their burden of buying drugs and paying for therapy services. Through the introduction of the ACA reforms, the number of the elderly patients and children under health insurances reduced. All the poverty related Medicaid coverages were renewed allowing the patients to get their services at little or no health care cost. The patients enrolled with Medicare were given an allowance to apply for the Medicaid enrollment. Eventually, the ACA reforms gave room to all the American citizens to enroll to the Medicaid program even without revealing their level income. 


Based on both the Medicare and the Medicaid analysis, it is evident that these initiatives have positively influenced the health status of the American citizens. In addition, the introduction of both Medicaid and Medicare has greatly helped in the containment of the chronic illnesses due to cost reduction. People living with disabilities also had an advantage of receiving costs at no cost thus improving their health status. Improving the health status of both the elderly and the disabled has positively influenced their relationship with the members of the society .the introduction of ACA have positively influenced both Medicare and Medicaid programs thus helping the American citizens to overcome the challenges associated with health. Therefore, the introduction of ACA, Medicare and Medicaid has positively influenced the economic growth in America. Eventually the mortality rates in the country have been reduced thus increasing the mortality age. 


Berkowitz, S. A., Terranova, J., Hill, C., Ajayi, T., Linsky, T., Tishler, L. W., & DeWalt, D. A. (2018). Meal delivery programs reduce the use of costly health care in dually eligible Medicare and Medicaid beneficiaries. Health Affairs37(4), 535-542.

Card, D., Dobkin, C., & Maestas, N. (2018). The impact of nearly universal insurance coverage on health care utilization: evidence from Medicare. American Economic Review98(5), 2242-58.

Danagoulian, S., Janke, A., & Levy, P. (2018). Medicaid Expansion After the ACA: Intensity of Treatment and Billing in Emergency Departments. Available at SSRN 3261600.

Grabowski, D. C., Joyce, N. R., McGuire, T. G., & Frank, R. G. (2017). Passive enrollment of dual-eligible beneficiaries into Medicare and Medicaid managed care has not met expectations. Health Affairs36(5), 846-854.

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