Medicare vs Medicaid: Nhungavhura Kuzere Nezve Musiyano, Kubvumidzwa & Kufukidzwa

Musiyano uripo pakati peMedicare neMedicaid unovhiringidza mamiriyoni evaAmerica gore negore uye mazita acho haasi kubatsira. Zvese zvirongwa zveutano zvefederal. Zvese zvinotanga ne "Medi." Zvese zvakatanga kushanda pazuva rimwe chete muna 1965. Zvisinei, zvinoshanda nevazvindi zvakasiyana, hazvishande nenzira imwechete, uye zvine mimwe mirau. Medicare inivhoridzi yeutano inoenderana nezera, kureva, kunyanya kune vanhu vane makore 65 kana kupfuura. Kufukidzwa kwehutano kunoenderana nemari kune vanhu vane mari shoma, zvisinei nezera ravo, ndiko kutsanangurwa kwe Medicaid. Kune vanhu ivavo vanokwanisa zvese.

Nhungavhura ino inokutendera iwe kuti uone kuti chirongwa chega chega chinoita sei, ndiani anokwanisa, zvinodhura sei, zvinofukidza sei, uye mashandiro anoita kugona kuwana zvese. Kunobva ruzivo iCMS, Medicare.gov, Medicaid.gov, uye KFF. 

Chii chinonzi Medicare uye chii chinonzi Medicaid?

Medicare muchirongwa cheinivhoridzi yeutano chefederal pakati pevanhu vane makore 65 kana kupfuura, uye vaya vane makore pasi pe65 vane mamwe matambudziko kana chirwere cheitsvo chekupedzisira. Inotsigirwa nebhajeti rekubhadhara kubva mumabasa ako wepabasa auri kubhadhara kubva paya pakawanda yehupenyu hwako hwebasa. Hapana mari, kana zvimwe zvinodiwa, zvinodiwa kuti uwane mukana wekubvumidzwa, uye mabhenefiti anowanzova akafanana munyika dzese.

Medicaid inhungavhura ye-federal-state, inopa kufukidzwa kwekurapa kune vanowana mari shoma. Nyika imwe neimwe inofambisa musiyano wayo, uye hurumende yepasi rose inoitsigira sezvakaita nenyika. Mirau, kubvumidzwa, uye mabasa akavharwa zvinosiyana zvakanyanya zvichienderana nenyika. Sekureva kwezvinyorwa zveCMS, vanhu vanosvika mamiriyoni 80 vakafukidzwa nechirongwa chikuru cheinivhoridzi yeutano muU.S., icho chiri Medicaid.

Chidimbu chipfupi icho vanachiremba veinivhoridzi vazhinji vanoshandisa: Medicare ndeyevakweguru, Medicaid ndeyemari shoma. 

Medicare vs Medicaid: kuenzanisa kwese-kwese

Musiyano weMedicare neMedicaid unoratidzwa zvakajeka pakuonekwa kwese-kwese. Zvese zvirongwa zvinofukidza kushanya kwachiremba, kugara muchipatara, nemishonga, asi kubvumidzwa uye dhizaini yemari zvakasiyana zvakanyanya.

Medicare ine zvikamu zvina (A, B, C, D), zvese zvinofukidza mabasa akasiyana. Medicaid ine chirongwa chimwe chete chikuru munyika imwe neimwe, nezvimwe zvinowedzerwa. Zvirongwa zvakasiyana zvakakwana zvekuti "Medicare vs Medicaid" hazvisi kumira zvakanaka zvevanhu vazhinji. mubvunzo chaiwo ndewokuti ndeupi waunokwanisa, uye kana uchigona kukwanisa zvese.

Ndeupi musiyano pakati pekubvumidzwa kweMedicare neMedicaid?

Medicare neMedicaid dzinosiyana sei nhamba yevanhu vanokwanisa? Zvese zvinodzikira kune zera nemari. 

Kubvumidzwa kweMedicare kunoda zera (65 kana kupfuura) kana kuremara. Medicare.gov inoti vanhu vazhinji vanokwanisa otomatiki kana ivo kana vavanoshanda navo vakashanda kwemakore 10 (40 quarters) vachibhadhara mitero yeMedicare. Vanhu vane makore pasi pe65 vanokwanisa kana vakagamuchira Social Security Disability Insurance (SSDI) kwemwedzi 24, kana vane ALS kana chirwere cheitsvo chekupedzisira. 

Kubvumidzwa kweMedicaid kunosiyana zvichienderana nemari, saizi yemhuri, nemirau yenyika yako. Kune zviyero zvepasi rose zvehurumende, asi nyika dzinopa miganhu yemari yadzo. Munyika dzakawedzera Medicaid pasi peACA, vanhu vakuru vanokwanisa kusvika pa138% yeFederal Poverty Level (inosvika $20,800 muna 2026). Munyika dzisina kuwedzera, miganhu yemari yakaderera zvakanyanya kana kuti zvimwe zviguru zvinokwanisa chete (vanasikana vane pamuviri, vabereki, vana, vanhu vane matambudziko).

Unoshandisa Social Security Administration kunyorera Medicare. Unonyoresa muMedicaid paungano yako yeMedicaid yenyika kana healthcare.gov. Kuti uwane zano renyika, muenzaniso wekuti mirau yenharaunda inoshanda sei, nhungavhura yedu ye Medicaid Illinois.

Chii chinofukidzwa nechirongwa chega chega?

Zvese zvirongwa zvinofukidza mabasa akawanda ekurapa, asi zvakadzama zvinoitika zvakasiyana.

Kufukidzwa kweMedicare:

• Chikamu A (chipatara): Kugara muchipatara, kuchengetwa kune dzimba dzekuchengeta vane mazvikokota, hospice

• Chikamu B (kurapa): Kushanya kwachiremba, kurapa kunze kwechipatara, mabasa ekudzivirira, michina yekurapa inogara. Ona nhungavhura yedu yakazara ye Medicare Part B kune zvakadzama.

• Chikamu C (Medicare Advantage): Chikamu A + B chakabatanidzwa (uye kazhinji D) kuburikidza nevanopa venyama

• Chikamu D (mishonga): Mishonga yekunze kwechipatara. Ona Medicare Part D explainer yedu

Medicare haifukidzi mazino mazhinji, kutarisa, kunzwa, kana kuchengetwa kwenguva refu. Iyi ndiyo kushamisika kwakajairika kune vanowana mabhenefiti matsva. Kuti uwane zvimwe nezve mabukira ezino, ona nhungavhura yedu yekuti Medicare inofukidza mazino.

Kufukidzwa kweMedicaid: Mutemo wefederal unoda kuti chirongwa cheMedicaid chenyika imwe neimwe chifuke chipatara nemabasa echiremba, marabhoritari neX-ray, kuronga mhuri, kuchengetwa kune dzimba dzekuchengeta, hutano hwedzimba kune vanokwanisa dzimba dzekuchengeta, kutakura kuenda kumisangano yekurapa, neEPSDT (kurapa kwekudzivirira) kune vana pasi pe21. Nyika dzinogona kuwedzera mishonga, mazino, kutarisa, physiotherapy, nezvimwe mabasa semabhenefiti anosarudzwa. Ona nhungavhura yedu ye Medicaid dental kune vakuru nenyika-ne-nyika semuenzaniso wekuti izvi zvinosiyana sei.

Medicaid inopa zvakanyanya pane Medicare pamusoro pekuchengetwa kwenguva refu. Mazhinji ekugara mudzimba dzekuchengeta vakweguru muU.S. anobhadharwa neMedicaid, kwete Medicare.

Unogona kuva neMedicare neMedicaid here?

Hongu. Vanhu vanokwanisa zvese vanonzi "dual eligible," uye vanosvika mamiriyoni 12.5 evaAmerica vanowanikwa muchikamu ichi, zvichienderana ne KFF research. Vazhinji vanhu vane makore 65+ vane mari shoma.

Kufukidzwa kweMedicare Medicaid kunoshanda seizvi: Medicare ndiyo inobhadhara yekutanga kune mabasa ekurapa ayo inofukidza, uye Medicaid inopinda kuti ibhadhare mari dzekunyorera dzeMedicare, copays, nemari dzekubvisa, pamwe nemabasa ayo Medicare isingafukidze (kuchengetwa kwenguva refu, mazino mazhinji nekutarisa).

Kufukidzwa kwakabatanidzwa ndeimwe yemafukidziro e-inivhoridzi yeutano akakwana kwazvo muU.S. Vanhu vanokwanisa kazhinji vanobhadhara $0 kubva muhomwe yavo kune angangoita ese ekurapa, kusanganisira mishonga kuburikidza ne Medicare Savings Program neExtra Help.

Kuti uone kana uchigona kukwanisa zvese, taura neState Health Insurance Assistance Program (SHIP) yako kana kunyorera kuburikidza neungano yako yeMedicaid munharaunda yako.

Mibvunzo Inowanzobvunzwa

Ndeipi iri nani, Medicare kana Medicaid?

Hapana kana imwe yacho iri "nani." Zvinoshumira vanhu vakasiyana. Medicare ndiyo chirongwa chakakodzera kana uine makore 65+ kana une kuremara kunokwanisa. Medicaid ndiyo chirongwa chakakodzera kana uine mari shoma, zvisinei nezera. Angangoita 1 muvashandisi veMedicare anosarudzawo Medicaid, izvo zvinovapa kufukidzwa kwakakwana kune chero nhungavhura yeU.S.

Ndinoda zvese Medicare neMedicaid here? 

Hauitongi kuti uve nazvo zvese. Unokwanisa zvese zvichienderana nezera nemari. Kana uine makore 65+ ane mari shoma, kunyorera zvese kwakakodzera kufunga. Zvirongwa zviviri izvi pamwe chete zvinobhadhara zvese zvekurapa, zvinosanganisira mari dzekunyorera, copays, nemabasa ayo Medicare isingafukidze. Taura nemurairidzi weSHIP kune rubatsiro rwemahara.

Ndinogona kurasikirwa neMedicaid kana ndawana Medicare? 

Kwete. Kana uka wanisa zvese, unova dual eligible. Medicare inova inivhoridzi yako yeprimari, uye Medicaid inoenderera mberi ichibhadhara mari dzekunyorera, copays, nemabhenefiti ekuwedzera. Haurasi kufukidzwa kweMedicaid nekuti chete wakwana makore 65 kana ukakwanisa Medicare. Migwagwa yemari icharamba ichishanda kuMedicaid, zvisinei, saka tarisa zvinodikanwa zvekudzoreredzwa.

Ndeipi inofukidza mari dzedzimba dzekuchengeta vakweguru? 

Medicaid inofukidza zvakanyanya kuchengetwa kwenguva refu mudzimba dzekuchengeta vakweguru muU.S. Medicare inongofukidza kusvika mazuva 100 ekuchengetwa kune dzimba dzekuchengeta vane mazvikokota, uye chete mushure mekugara muchipatara kunokwanisa. Mushure mekunge muganho weMedicare wapera, mhuri dzinowanzobhadhara zvavo kana kunyorera Medicaid. Angangoita 60% evagari mudzimba dzekuchengeta vakweguru munyika yose vane mari yavo yekurapa inobhadharwa kuburikidza neMedicaid.

Medicare kana Medicaid inofukidza mazino here? 

Yakagadziriswa Medicare (Zvikamu A neB) haifukidzi mazino mazhinji. Zvirongwa zveMedicare Advantage kazhinji zvinosanganisira kufukidzwa kwezino. Kufukidzwa kweMedicaid kwemazino kunosiyana zvakanyanya nenyika. Vamwe vanofukidza mazino akakwana kune vakuru, vamwe vanongofukidza kungoita mazino ekukurumidzira. Vana vari paMedicaid vanowana kufukidzwa kwemazino akakwana munyika dzose pasi pemirau yeEPSDT yepasi rose.

Chikamu chepasi

Medicare vs Medicaid is less comparison and more a question of which one applies to you. Medicare is age-based federal health insurance for people 65+ and certain people with disabilities. Medicaid is income-based health coverage that varies by state. About 12.5 million people qualify for both and benefit from the most comprehensive coverage available. If you're approaching 65, applying for Medicare through SSA is automatic for most people. If you have low income, applying for Medicaid through your state agency is the path. If you're not sure which applies to you, your state's SHIP counselor provides free, unbiased guidance.