Difference Between 医疗保险 and 医疗补助计划

What are the differences?

Although 医疗保险 and 医疗补助计划 are two very different programs, they strive to achieve the same goal; to provide medical and health-related services to specific groups of people in the United States. 医疗补助计划 is a public insurance program that provides healthcare coverage to low-income families and individuals, 包括老年人, 父母, 孩子们, 孕妇, and people with disabilities. 医疗保险 is also a public insurance program and it provides payment for hospital and medical care for elderly and certain disabled Americans. 医疗补助计划 is jointly funded by the cooperation of the federal government and the states.

Each state operates its own 医疗补助计划 program within federal guidelines. Because the federal guidelines are broad, states have a great deal of flexibility which results in each state having its own local customs. Consequently, 医疗补助计划 eligibility often varies from state to state.

In 2013, according to the Congressional Budget Office, 医疗补助计划 is estimated to have provided healthcare coverage for roughly 57 million Americans over the course of the year. This includes approximately 20 million adults, 600万老年人, 2800万儿童, and 11 million persons with disabilities. In 2010, 21 percent of the population was at some point enrolled in the 医疗补助计划 program.

• 资格: 医疗补助计划 covers low-income and financially needy people, including those over 65 who are also on 医疗保险. Because the federal rules are open to interpretation, local customs can mean that the eligibility rules are enforced differently from state to state.
• State Administration: 医疗补助计划 is administered by the 50 states with application of the rules differing in each state.
• 提供覆盖: The amount of coverage varies from state to state. 在一般情况下, 医疗补助计划 provides inpatient and outpatient health care coverage, including coverage for prescription drugs, diagnostic and preventive care, 和眼镜.

医疗补助计划 can assist in paying your 医疗保险 免赔额 along with charges not paid by 医疗保险.

医疗保险

医疗保险 is strictly a federal program which was created to assist with the high medical costs faced by older Americans who often are also dealing with a reduction in their ability to earn a living wage. Unlike 医疗补助计划, eligibility for 医疗保险 is not tied to an individual need. 而不是, it is an entitlement program; you are entitled to it because you or your spouse paid for it through Social Security taxes.

Although you may qualify for and receive coverage from both 医疗保险 and 医疗补助计划, you must meet separate eligibility requirements for each program; being eligible for one program does not necessarily mean that you are eligible for the other. If you qualify for both, 医疗补助计划 will pay for most 医疗保险 Part A and B premiums, 免赔额, 和共同支付.

• 资格: 医疗保险 covers almost everyone aged 65 or older, certain people on Social Security disability, and some people with permanent kidney failure.

• Federal Administration: 医疗保险 is a federal program whose rules are the same all over the country. 医疗保险 information is available at your local Social Security office.

• 提供覆盖: 医疗保险 hospital insurance (Part A) provides basic coverage for hospital stays and post-hospital nursing facility and 家庭保健.

医疗保险 medical insurance (Part B) pays most basic doctor and laboratory costs, and some outpatient medical services, including medical equipment and supplies, 家庭保健, and physical therapy.

医疗保险 prescription drug coverage (Part D) pays some of the costs of prescription medications.