MEDICARE VS MEDICAID

Medicare is a program that pays for medical costs of eligible individuals.  Unlike Medicaid which is a welfare program; Medicare is an insurance program.  Medicare pays for acute care, limited skilled nursing care, hospitalization, doctor's fees, and in certain situations, medications used in hospital and home care.

Medicare is divided into three parts:  Part A covers hospital care; Part B covers physician and outpatient services; and Part C is a new managed care program that is now called Medicare Part C + Choice Program.

Seventy three percent of Americans incorrectly think that Medicare is the primary funding source for long term health care. (Gallup Organization Inc., Public Attitudes on Long Term Care: The EBRI Poll. August, 1993; 15.)

Does Medicare cover long term care?

Medicare does not even begin to address the needs of a society that is living longer and longer. When Medicare was first developed in the mid-1960s, we had only limited knowledge regarding the special needs of elderly people, including chronic care needs.

Why does Medicaid pay the nursing home care costs for so many elderly nursing home residents when Medicare is supposed to take care of the elderly's health care needs?

While originally intended to meet the poor's health care needs, Medicaid became America's long term care system by default because the nation lacks any comprehensive long term care program. Many elderly middle-class citizens must rely on Medicaid to pay for long term care because they have exhausted virtually all of their life savings and assets to pay for their care. Most spend down their assets within one year of being admitted to a nursing home.

Medicare, on the other hand, pays for the elderly's doctor visits, emergencies and short term illnesses, but not for long term care. Medicare does offer a limited benefit for nursing home care, but only following a three-day hospital stay.