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Dhaka Tribune

Obamacare versus Medicaid, Medicare

Update : 20 Mar 2017, 06:37 PM

Obamacare, formally known as the Affordable Care Act, vast and often misunderstood, contains a multitude of components which, taken in sum, are aimed at sharply reducing the number of uninsured Americans while slowing the rapid growth in the nation's health care spending.

Obamacare did not create a public insurance program. It is a legal framework that imposed obligations on private insurers, and individuals, in order to better regulate the market and expand coverage.

Only two US federal health insurance programs exist: Medicaid, for the lowest-income families and individuals; and Medicare, for those over 65. Most other Americans are insured in the private sector, usually through their employer.

Here is how Obamacare, Medicaid and Medicare works-

Obamacare

The Affordable Care Act (ACA) is designed to make healthcare more affordable for more US citizens. It accomplishes this by creating laws that prohibit an insurance company from dropping citizen's coverage if they become sick or injured, eliminate the possibility of being charged more because of a pre-existing condition or discriminatory reason such as gender, and protect against unjustified hikes in insurance rates. There are, however, penalties for not having health insurance under the ACA. If anyone does not have health coverage, and make more than a certain amount a year, he has to pay a fine on his taxes. It also requires that large scale employers offer health insurance coverage to their employees.

Medicaid

Medicaid, in contrast to Obamacare, is not designed for anyone to take part in. Medicaid is designed to offer either free, or low cost health care coverage to those in need. While the ACA is done through the federal government, Medicaid is handled by the state. Those who are eligible for Medicaid include-

Pregnant Mothers: If a woman is having a child, regardless if she is married or single, she may qualify for Medicaid for her and the child.

Parent of a Minor: If a parent have a child already born and is under the age of 18, they may qualify for Medicaid coverage depending on their financial situation, or if their child requires nursing home care or home care due to a sickness, Medicaid may be able to help as well.

Disabilities: If a citizen is physically disabled, he may eligible to apply for Medicaid. This is also extended to elderly individuals who cannot afford the premiums associated with Medicare.

Low Income Individuals: If anyone does not fall under any of these circumstances, they may still be able to qualify for Medicaid if they are in a low-income situation.

Medicare

Medicare is a program designed to help people over the age of 65, along with some younger individuals who have certain disabilities. While they may have to pay a premium, the main cost of their Medicare is paid for through your working years. Part of what is taken out of their paycheck each week now is what pays for their Medicare once they reach retirement age. Currently, Medicare benefits come in four parts.

Part A: Hospital Care. This part pays for time spent in a medical facility.

Part B: This part covers tests and procedures, meaning what happen to you while in the hospital or medical facility. Part B coverage requires a premium.

Part C: Done as an alternative to normal Medicare coverage, Part C is known as Medicare Advantage plans, offers the benefits of Part A, B, and D, and is administered through private insurance companies.

Part D: Part D covers prescription drug coverage. Part D is a required benefit of Medicare, unless you obtain it from a different source.

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