need help for medicare and medicaid

[ricced]

hi im in my 2nd semester in nursing class and were having our first test this coming week. i was wondering if anyone could help me define the difference between medicare, medicaid and private insurance? thank you guys

[Daytonite, BSN, RN]

medicare - government program funded through taxation that provides payment for health care services for the elderly and certain categories of illnesses; federally funded program that provides health insurance for the elderly and certain other groups; established in 1965 by title xvii health insurance for the aged of the social security act of 1935, now referred to as medicare; entitlement program (title xvii)) enacted by the u.s. congress and effective july 1, 1966, as an amendment to the social security program. it provided health care payment for all participants 65 years of age or over. (page 795)

mediaid - jointly funded program between the state and federal governments to provide health care to welfare recipients in the different states; originally titled the medical assistance program; established by title xix or the social security act; entitlement program (title xix) that provides health care for low-income people. (page 794)

private insurance - purchased contract (policy) in which the purchaser (insured) is protected from loss by the insurer's agreeing to reimburse for such loss. (page 790).

[all above from health information: management of a strategic resource, 2nd edition, mervat abdelhak, sara grostick, mary alice hanken and ellen jacobs]

you can go on the internet to the websites for medicare (also known as cms) and your state medicaid agency to get more information. each state must follow certain federal guidelines, but is allowed to set some restrictions on what they will cover in medicaid services. so, each state's medicaid program is set up a little differently. this is different from medicare. no matter where you live, medicare coverage is the same whatever state you live in. there are all kinds of private insurance companies. what distinguishes them from the government insurance is that they enter into contracts with the people or companies with who they do business. those contracts clearly outline what services they will and will not pay for and it can be anything from soup to nuts.