The Medicare Essentials

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Source: Kaiser Family Foundation

The Medicare program was enacted by President Johnson in 1965 under Title XVIII of the Social Security Act to provide those over the age of 65 with health care, regardless of income or medical history. It is a single-payer program funded by the federal government through payroll taxes, premiums paid by beneficiaries, and general revenue.In 2016, the federal government spent $675 billion [or 15% of total federal spending] on Medicare coverage. 

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The Medicaid Eligibility Game

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Medicaid is jointly administered by the Centers for Medicare and Medicaid Services (CMS) and individual state Medicaid agencies. CMS is an agency within the Department Health and Human Services (HHS), which in turn is overseen by the President. CMS sets program parameters, provides policy guidance, and approves waivers excusing states from certain requirement. CMS issues guidance on eligibility, enrollment, medical assistance, coverage, provider participation, provider payments, cost-sharing, and a host of other policy issues related to the program.

In turn, each state creates a uniform, state-wide medical assistance program that is embodied in a federally-approved state plan. The state agencies are free to make choices within the parameters set by the federal government, often through waivers or creative programming.

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