Final answer:
An individual eligible for both Medicare and Medicaid is known as 'dual eligible'. Medicare serves people over 65 and those with disabilities, while Medicaid assists low-income individuals, including those near or below the poverty line, with varying eligibility based on state thresholds.
Step-by-step explanation:
An individual qualifying for both Medicare and Medicaid benefits is referred to as a 'dual eligible'. These programs are key elements in providing healthcare to different groups in the United States. Medicare is primarily for those over the age of 65 or with certain disabilities, covering expenses like hospital stays, physician services, and other medical needs. Medicaid, on the other hand, helps low-income individuals and families, including the near-poor, as well as certain other groups such as the low-income elderly and people with disabilities.
Medicaid is a federal-state joint program enacted in 1965 to offer medical insurance for low-income individuals. This includes those living around or below the poverty line, and focuses on particular demographics such as low-income families with children, the low-income elderly, and the disabled. Being a joint venture, it is partially funded by the states, which can set their own income eligibility thresholds - sometimes leaving individuals without coverage in more restrictive states.
The Affordable Care Act (ACA) aimed to expand Medicaid coverage by providing additional federal funds to states that agreed to raise the income threshold for eligibility. However, some states have chosen not to expand their programs, affecting overall access to Medicaid. The comprehensive health benefits provided to individuals in the Medicaid program might have limited access to care due to fewer healthcare providers accepting payments from Medicaid, as it often reimburses less than Medicare.