The Difference between Medicare and Medicaid in the United States.
Medicare and Medicaid are government healthcare services for the old, disabled and poor in the United States.
Medicare in the US.
Medicare is federal health insurance for people 65 or older, and some people under 65 with certain disabilities or conditions.
People with Medicare pay part of the costs through things like monthly premiums for medical and drug coverage, deductibles and coinsurance.
Medicaid in the US.
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. This means eligibility requirements and benefits can vary from state to state.
People with Medicaid usually don’t pay anything for covered medical expenses, but may owe a small co-payment for some items or services.
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How Medicare Advantage plans use algorithms to cut off care for seniors in need.
Older people who spent their lives paying into Medicare, and are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or get by without it.
One example starts with this:
An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.
On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, even though her pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.
https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence