Description of Medicare and Medicaid in the USA

Medicare

This is one of the huge federal government websites that is paid and managed for the USA health care centers and other services.

Medicaid

There are about six centers for medical and Medicaid services centers in the USA and Medicaid and chip services are one of them.

Major features of Medicare and Medicaid

Medicare features

·         There are some features of Medicare that involved

·         They are providing hospital inpatient services to the citizens

·         They are also providing hospital outpatient services to the citizens.

·         Also providing home health services to old citizens.

Medicaid features

·         The important features of the Medicaid are given below

·         They are providing health care services to the low assets citizens

·         They are providing health services to millions of American

·         They are providing health care services to pregnant women, children, adults, and people with certain disabilities (Ncbi, 2019).

Difference between these programs

There are a lot of similarities that are present between these programs. But the most important thing is to know what the main differences present between these programs are? In this section, there is a complete detail about the different present between these two programs that are issued by the federal government of America.

·         It can be noted that both Medicaid and Medicare are totally two different programs that are run by the federal government.

·         Moreover, both of these programs are operated by different parts of the government.

·         Medicare is that program that is organized by the federal government of the country for the people that are about 65+ or under this age and contain any disability no matter what is your income this program will facilitate you with important services

·         On the other hand, Medicaid program is involved in providing health services to that citizen that contain low income for a living (Medicareinteractive, 2019).

How to bill for each program

For Medicaid

Medicaid billing is extremely complicated. This is because it varies from one state to another. For  billing, you have to mention your state then according to that you will be eligible for the services. In many states that are providing Medicaid services are dividing their claims into two equal parts. In the first part, there is complete information about the patient and in the second part, there is some information regarding the health care provider. Then after this, the patient has to input some codes from the code sets. These code sets are

·         ICD-9-CM codes

·         Health care common procedures code

·         CPT (Current procedural terminology) codes  

·         Place of service codes

For Medicare

This program is also known as a single player healthcare system. Before billing for Medicare there is some important information that should be provided in this section. The first one is related to the information from the provider’s superbill. Then after this take a print out of the paper for the sake of processing. Then after this, the patient needs to enter the medical codes like for Medicaid. For the billing, the Medicare program is divided into three sections.

·         Part 1 is related to the medically necessary services

·         Part 2 is related to preventative care

·         Part 3 is needed to fill in the separate paper (Medicalbillingandcodingonline, 2019)

Do active military service members have a choice to enroll in TRICARE or not? Do they have non-TRICARE options they could elect in?

TRICARE is a program run by the United States Department of Defense Military Health System. The beneficiaries of the Military health system have a choice to enroll in the TRICARE plan. However, the enrollment in the TRICARE plan will be based on their status for instance whether they are reservists, active duty family members or Medicare eligible, etc. 

References of Description of Medicare and Medicaid

Medicalbillingandcodingonline. (2019). Medical billing and coding online. Retrieved from https://www.medicalbillingandcodingonline.com/billing-for-medicair-medicaid/

Medicareinteractive. (2019). Differences between Medicare and Medicaid. Retrieved from https://www.medicareinteractive.org/get-answers/medicare-basics/medicare-coverage-overview/differences-between-medicare-and-medicaid

Ncbi. (2019). Overview of the Medicare and Medicaid Programs. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194683/