Medicaid has taken a giant and important leap recently. Because of this move forward, it is now possible that thousands of people will be able to get home-based care rather than being institutionalized. This new provision allows people to get care in their homes or in the community instead of an institutional setting.
The Deficit Reduction Act (DRA) allows states to provide people who qualify for Medicaid benefits to receive this care without having to apply for a demonstration waver to prove their eligibility. Having the option as to how an individual will receive long-term support is an historic step in leveling the playing field.
Individuals will now be able to receive person-centered care and have a part in the development and decision making about that care. Some of the services that states will be able to provide under this new provision will be case management, homemaker, home health aide, personal care, adult day health and respite care. In addition, individuals with chronic mental illness can receive day treatment, partial hospitalization, psychosocial rehabilitation and clinic services.
This new provision is an essential step in helping individuals with disabilities have the choice to be part of and participate in the community, stay in their own comfortable surroundings, make choices regarding services and have the support of a program that will offer them these options and more.
Many people have questions about Medicare and Medicaid including the question of what the differences are between the programs. There are some major differences between the two.
Medicare is funded by the federal government as an entitlement program, which mainly focuses on the older population. It is a social insurance program for individuals age 65 and over and it covers many individuals with disabilities. Medicare also covers individuals of all ages with end stage renal disease.
There are several parts to Medicare. Part A covers hospital bills, Part B covers medical insurance and Part D covers prescriptions.
Medicaid is different from Medicare in several ways. It is also an entitlement program, however, Medicaid is not funded only by federal government, there is a state component as well, and in some states, counties pay part of the cost.
Medicaid is based on need and social welfare, with eligibility based on income. If a person has limited income and/or financial resources, Medicaid covers a broader spectrum of services than Medicare does. It usually covers children, pregnant women, parents of eligible children, seniors and individuals with disabilities. Though poverty is used to determine eligibility, a person must fall into one of the coverage groups in addition to being determined eligible due to being in poverty. Medicaid benefits are paid directly to the provider of services. In addition to covering individuals who meet financial requirements, in some states Medicaid covers individuals who cannot otherwise afford insurance.
Some individuals qualify for coverage by both programs.
