Medicare vs Medicaid

MEC is a broad category that includes employer plans, Medicare, Medicaid, and other coverage satisfying the coverage requirement, while a QHP is a specific exchange-certified plan. — Minimum Essential Coverage (MEC) is the umbrella category of coverage that satisfies the ACA individual coverage requirement. It includes employer-sponsored plans, individual market plans, Medicare, Medicaid, CHIP, TRICARE, and other government programs. A Qualified Health Plan is a narrower concept: a specific commercial plan certified by an exchange and offered through it. Every QHP is one type of MEC, but much MEC is not QHP — for example, an employer plan or Medicare is MEC but not a QHP. Understanding this subset relationship is a definitional question in the PPACA section of the A&H outline.

National insurance concept

Are eligible for both Medicare and Medicaid — Special Needs Plans (SNPs) are a type of Medicare Advantage plan tailored to specific beneficiary populations. The D-SNP serves dual-eligible beneficiaries — people entitled to both Medicare and Medicaid — and typically coordinates the two programs' benefits, including covering Medicare's deductibles and coinsurance that Medicaid would otherwise pick up. Other SNP categories serve institutionalized residents (I-SNP) and beneficiaries with severe or disabling chronic conditions (C-SNP). The D-SNP is the highest-profile SNP type because of the large dual-eligible population.

National insurance concept