Medicare vs. Medicaid - Essay Example

Part Medicare and Medicaid are of primary consideration in the service sector involving health security. The vast amount of priority laid on the administration of such programs points to the significant role they are playing in the nation’s growth and development. Medicare program evolved as an important consideration of the republic and particularly of the Congress. The administration of Medicare and Medicaid is mainly carried out by the Centre for Medicare and Medicaid Services (CMS), which is a component of the Department of Health and Human Services (HHS).

(Medicare (United States). 2007). Department of Health and Human Services (DHMS), along with some other agency holds the overall responsibility of the program. The Health Care Financing Administration (HCFA) administrates the general financing policy formulation and other responsibilities of Medicare. The professional health aspects of Medicare are under the responsibility of the Public Health Service (PHS) and there is the Social Security Administration (SSA), which is entrusted with the responsibility of maintaining the Medicare master beneficiary record and others.

Other agencies that are related to the administration of Medicare are the Department of Treasury, the Board of Trustees and State agencies like State Health Departments. (The Health Law Resource. Overview of Medicare. 1994). Part 2 To identify the significance of Medicare in the nation is illustrated by the fact that it forms the second largest segment of the federal budget. There are two parts in the program and they are Hospital Insurance and Supplementary Medical Insurance. A comparison between Medicare and Medicaid is of great significance.

It is quite a necessity to distinguish between the two programs as many find it hard to find the difference. Medicare is an entitlement program whereas Medicaid is a federal program for the needy established by the Federal government but differently administered in each state. Though accessible to anyone, separate eligibility is needed for both of them. To base our understanding on the program comparison made by Lewis Golinker, the eligibility for Medicare is not income based whereas it is so in the case of Medicaid.

Mainly Federal Government administers Medicare whereas State Governments manage the Medicaid programs. In both cases, SLP report and doctors prescription are needed for claim. Judicial review for Medicare is available in Federal court and it is available in State as well as Federal court in the case of Medicaid. (Medicare vs. Medicaid: Program Comparison. April 2001). Part 3 There are several factors that determine the ability of the members to get reimbursed. It is very important that the person be very well informed of those factors.

The components that determine the ability change from case to case. Reimbursement for many a cases has been inconsistent. There is a complex and ever evolving system of rules and regulations in the reimbursement of the claims. Schools and related agencies help in this regard. One of the major abilities is that of identifying the right agencies and parties that are part of the procedure. Many agencies help in the procedure. However, the ultimate jurisdiction is that of the members. The members themselves make the essential choice.

As the reimbursement payment system is much complicated, the members should posses many such qualities. References Medicare (United States). (2007). Wikipedia. Retrieved October 20, 2007, from http://en.wikipedia.org/wiki/Medicare_(United_States)#Administration The Health Law Resource. Overview of Medicare. (1994). Retrieved October 20, 2007, from http://www.netreach.net/~wmanning/medicare.htm Medicare vs. Medicaid: Program Comparison. (April 2001). Retrieved October 20, 2007, from http://www.nls.org/conf/medicare-medicaid.htm