As a primary provider of Medical Consulting in Mequon, Wisconsin, allow us to tackle Medicaid in this article along with the changes set to happen to the program this year.
Medicaid versus Medicare: Primary Differences
Medicaid and Medicare are both healthcare programs run by the government. But there are four key factors that differentiate one from the other.
- Primary Runners
Medicare is a national program, meaning, its rules and reforms are implemented country-wide. Medicaid is state-dependent. Its regulations and reforms depend on local legislators and their implementation limited within the state’s boundaries.
- Membership Qualification
Medicare caters to older adults (65 years old and above) and younger recipients with disabilities regardless of their incomes. On the other hand, Medicaid is intended for members of low-income families irrespective of their ages.
Medicaid covers the costs of basic healthcare including doctor’s visits and hospitalizations. It also covers nursing care should the recipient need it. Medicare consists of several plans that cover different healthcare services – doctor’s fees, hospital and post-hospital charges, outpatient and therapy care, and prescription drugs.
Medicaid beneficiaries have to pay a small amount for some of the services they receive. Medicare enrollees, on one hand, pay monthly premiums for their plans and 25% of their drug costs.
Medicaid Changes in Wisconsin
Wisconsin didn’t implement Medicaid expansion as stated in the Affordable Care Act (ACA). But it’s the only non-Medicaid-expansion state that doesn’t have a coverage gap. It also caters to all of its low-income residents through BadgerCare.
However, newly-seated Wisconsin governor Tony Evers is set to push the state’s Medicaid program expansion, which is something that both patients and practitioners of medical practices in Wisconsin should wait up for.
Where Do I Start?
Regulations to familiarize and paperwork to comply generally come with healthcare program changes. And for medical practitioners, these mean additional burden. But these matters are responsible for the existence of consulting services firms like Acuity Revenue Consulting – to help make this part of the business industry easier to handle.