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联邦医疗保险及州医疗保险的区别

                                               Medicare vs Medicaid                                       
                                   文章摘编自http://www.visitorscoverage.com/health-insurance/medicare-vs-medicaid/

        New immigrants to USA often want to know more about the different govt. sponsored health insurance programs like Medicare, Medical and Medicaid for green card holder or new immigrants like parents, relatives and dependents. Here is some useful information for our readers.

Medicare 


Medicare is a US Federal health Insurance program administered by the United Federal government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria.
Medicare has Part A (Hospital Insurance), Part B (Medical Services), Part C (Managed Health Care) and part D (Prescription Drugs)

Medicaid is health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states. Each state may have its own name for the program. Examples include "Medi-Cal" in California, "MassHealth" in Massachusetts, and "TennCare" in Tennessee

Medi-Cal is the name of the Medicaid program in the State of California. It is meant for individual and families with low income and resources. It is jointly administered by the California State Department of Health Care Services and the Centers for Medicare and Medicaid Services (CMS)


Eligibility

 Medicare 
1) Either US citizens & Permanent residents 65 or older, who or their spouses have worked and paid Medicare taxes in the US for 40 quarters.

2) Permanent Residents above age 65, who have lived in the USA can purchase Medicare from the government.

3) Disabled residents under 65 years of age and have been receiving either Social Security benefits or the Railroad Retirement Board disability benefits for at least 24 months from the date of entitlement.

4) People with end stage renal disease or need kidney transplant.

5) Eligible for Social Security Disability Insurance and have amyotrophic lateral sclerosis (ALS-Lou Gehrig's disease).

Medicaid 
1) limited income is one of the primary requirements for Medicaid eligibility.

2) Other requirements include, but are not limited to, age, pregnancy, disability, blindness, income and resources, and one's status as a U.S. citizen or a lawfully admitted immigrant.

3) Special rules exist for those living in a nursing home and disabled children living at home. A child may be covered under Medicaid if she or he is a U.S. citizen or a legal resident of the U.S

4) A child may be eligible for Medicaid regardless of the eligibility status of his or her parents or guardians.

5) Patients with Aids with T cell count of 200 or under

6) Must be resident of the plan offering state.

Medi-Cal 
1)Having a limited income is one of the primary requirements for Medicaid eligibility.

2) Other requirements include, but are not limited to, age, pregnancy, disability, blindness, income and resources, and one's status as a U.S. citizen or a lawfully admitted immigrant.

3) Special rules exist for those living in a nursing home and disabled children living at home. A child may be covered under Medicaid if she or he is a U.S. citizen or a legal resident of the U.S.

4) A child may be eligible for Medicaid regardless of the eligibility status of his or her parents or guardians.

5) Patients with Aids with T cell count of 200 or under

6) Must be a resident California state.

Benefits / Services

Medicare
1) Part A Hospital Insurance helps cover inpatient care in hospitals, including overnight hospitalization in hospitals, and skilled nursing facilities. It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits

2) Medicare Part B (Medical Insurance)helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. 

3) Medicare Part C 
is managed care 

4) Medicare Part D
 is Prescription drug coverage to help lower the price of prescription drugs

Medicaid
1) Inpatient hospital services

2) outpatient hospital services

3) prenatal care

4) vaccines for children

5) physician services

6) Nursing facility services for persons aged 21 or older. 

7) family planning services and supplies

8) rural health clinic services

9) home health care for persons eligible for skilled-nursing services

10) laboratory and x-ray services

11) pediatric and family nurse practitioner services

12) nurse-midwife services

MediCal
1)Clinic Services

2) Drug and Alcohol

3) Inpatient/Outpatient Services

4) Long Term Care

5) Medical case Management

6) Mental Health 7)Physician Administered Drugs

8) Physician Services

9) Podiatry Services

10) Vision Care Services.

11) Pharmacy Services.

12) Durable medical equipments like wheelchair, hearing aid, and their maintenance


Coverage Start date

Medicare 
If you already receive Social Security Benefits, you will automatically be enrolled into Medicare on the month you turn 65 years old.If you are close to 65 years of age and do not receive social security benefits yet, there are two periods of the year that you can enroll

1) Initial Enrollment Period (IEP) for Parts A and B is 7 months, starting 3 months before the month of you turn 65 years old and ending 3 months after the month of eligibility.
2) General Enrollment Period extends from January 1 through March 31 each year. Enrollment becomes effective on July 1 of the same year.

Medicaid 
No Specific dates Coverage may start retroactive to any or all of the three months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change.

MediCal 
No Specific dates. Coverage may start retroactive to any or all of the three months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change.

For Immigrants

Medicare  
If you are a new immigrant aged 65 and above, and been a permanent resident for 5 years or more, you may purchase Medicare from the government.

For a new immigrant, the only available immediate health insurance solution is to get a short term Health insurance.
See more information about insurance for green card holders

Medicaid  
If you are a new immigrant, and satisfy the eligibility criteria, you can call up the Medicaid Services in your state.

MediCal  
If you are a new immigrant, and satisfy the eligibility criteria, you can call up the Medical Services.

( Note: This article is for general information. Please contact the respective govt. body to get the latest information. )

For More Information

For More Information On Medicare visit http://cms.hhs.gov/home/medicare.asp

For more information on Medicaid Services Please Visit http://cms.hhs.gov/home/medicaid.asp

For more information on MediCal Services Please Visit http://www.medi-cal.ca.gov/

For a green card holder new immigrant, the only available immediate health insurance solution is to get a short term Health insurance.
See more information here. : Health insurance for Green Card holders.

Please contact us for more information via email or call toll free 866-384-9104. Our qualified licensed health insurance agents can assess your situation and help you with a solution.

Medicare or government sponsored health benefits programs: 
Once you complete 5 yrs or more on a Green card status and are continuously living in USA, you may apply for medicare.