Question

Briefly define the qualifications for Medicare and Medicaid benefits. How can qualifications be modified to serve more people who are considered a vulnerable population?

Answer 1

Medicaid and medicare healthcare benefits are program by the US government designed and implemented for covering the cost of healthcare for American citizens. These programs have been implemented since 1965 and funded by the taxpayers as a social healthcare programs focused on healthcare coverage for maximum citizens possible. However the Medicare and medicaid have similar sounding names and different eligibility criteria to qualify for the benefits. The following are the qualifications for Medicare and Medicaid benefits:

1. Medicare: Medicare is the healthcare coverage which has qualification criteria as 65 years of age & older and people with certain disability as beneficiaries. The qualification for eligibility is independent of the income levels. The medicare also covers the equipment and medical services which includes lab work, diagnostics such as X-rays, lab works, doctor's visits, wheel chairs, outpatient surgeries, etc

2. Medicaid: Medicaid is the healthcare coverage which has qualification criteria based on the income level of the individuals and medicaid is often regarded as last resort to healthcare for people who do not have any other access to benefits.As of 2020, the income eligibility for qualification for medicaid is income less than $2,349 per month and age above 65 yrs of age and this applies to nursing home, assisted living and in home care types of medicaid. The medicaid benefits such as nursing homes, laboratory tests and diagnostics, hospitalizations, etc varies from state to state and not uniform in nature

The following are the qualifications that can be modified to serve more people who are considered a vulnerable population for medicare:

1. The qualification criteria for the vulnerable population in medicaid and medicare have to be modified firstly on gender, sexual orientation and ethnicity basis of inclusion. These groups are the most likely to be left without any healthcare coverage and her vulnerability compounds their health problems and this can have impact on the overall healthcare programs outcome.

2. The hey aspect of the income levels criteria of $2,349 has to be reconsidered and readjusted taking into account the income drop due to depression like economy and lack of employment opportunities de to massive lay off. This has major impact on the vulnerable populations which even in the normal circumstances cannot find a job easily and their access to healthcare coverage is impacted seriously.

3. The qualification of disabilities in medicare should be expanded to all or more disabilities including the vulnerable population can help with improve healthcare coverage and have a major impact on the social aspect of healthcare especially key in such healthcare and pandemic crisis.

4. The qualification criteria can be adjusted on the cost sharing and offering subsidies with focus on modified benefit design which can help serve more people with a wider reach including the vulnerable populations.

5. The qualification for vulnerable population individuals with complex and sever chronic medical conditions at the baseline can be modified to include all health conditions can help cover all the cost and improve the healthcare in these vulnerable population and removed the stigmatized and ignored population of the society. This can help set a historical healthcare inclusion step to achieve the universal healthcare initiative that medicare and medicaid aims at.