Question

Compare and contrast Medicare Advantage plans and Medicaid plans. What are some of the distinctive differences as defined by Kongstvedt?

Answer 1

In America Health care program from government provide health care cost coverage for all Americans..Medicare and medicaid play a important role in covering their health care cost..Basic difference between medicaid and medicare is the eligibility for each program..Medicare is for people those who are 65 years or older and young people with some disabilities and end-stage renal failure..If you paid 10years medicare taxes and if you are married and spouse fulfilled the 10years work requirement can receive medicare benefits..
But medicaid is different from medicare that help cover medical cost for the people with low income and financial resources..Medicaid cover children under 19 years and their parents when you have financial resources..
Medicaid and medicare covers health care cost for doctor visit,hospital stay,prescription drugs and medications..but the way they providing coverage will be different..That medicare divided into part A which covers hospital services, Part B covers doctors visit,part D covers prescription drugs costs..Medicaid covers all this in a single program that is part C medicare advantage plans use..
Medicare provide limited coverage for long-term care,more to skilled nursing facilities for short period of time..but medicaid covers cost for nursing homes,assisted living facilities,long-term care as long as necessary..
federal government runs medicare, so other state might not qualify for medicare..medicaid is joint federal and state program..sometimes people eligible for both medicare and medicaid when they are financial challenges that is called 'dual-eligible'..They get some of the premium and co-payment costs that is under medicare and medicaid can fill the gap when medicare will not cover the costs..
As per Kongstvedt concern on managed care (medicare and medicaid) has many difference for financing or delivering health care..Fee=for-service(FFS) continue to be an important component of medicaid program design and spending..To identify the success in managed care need improvement strategies in available data..Effective managed care program promote care management and care coordination and it provide greater control and predict ability on state spending..It improve program accountability for performance,access and quality..There is difference in large part in population served and how the program designed statutory requirement for the program..There is difference in role of provider network,the process of enrolling in a managed care plan and its choices,cost sharing in the managing utilization..