Medicare versus Medicaid

by Paradise Living Center

medicare1

Despite having similar sounding names Medicare and Medicaid are two completely different programs. To add to the confusion, both are government programs that help people pay for healthcare. That’s where the similarities end. Some individuals may be eligible for both programs and these people are referred to as “dual eligible.” If you fall under this category, often times the two programs work together to cover most of your healthcare costs.

The comparison

The primary difference is that Medicare is generally for people with a disability or those older than 65 years of age, while Medicaid is for people with limited resources and income.

MedicareMedicaid
Provided by federal governmentProvided by state governments
Your coverage depends on what you chose and can include:·  Services and care received as an inpatient in a hospital or skilled nursing facility (Part A)·  Visits to your doctor, services and care received as an outpatient, and some preventative care (Part B)

·  Prescription medication (Part D)

 

*Note – Medicare Advantage Plans (Part C) combine A and B coverage, and often include D too – an all in one plan.

Each state provides its own programs, following federal guidelines. Medicaid provides both mandatory and optional benefits. In part, mandatory benefits include:·  Services and care received in a hospital or skilled nursing facility·  Services and care received in a federally-qualified health center, rural health clinic or self-supported birth center (licensed or recognized by your state)

·  Services provided by a doctor, nurse midwife, certified pediatric or family nurse practitioner s

 

Costs depend on the coverage you choose. Costs can include co-pays, premiums, deductibles and coinsurance (a type of insurance in which the insured pays a share of the payment made against a claim).Costs depend on your states’ rules and your income. Costs can include co-pays, premiums, deductibles and coinsurance. Certain groups are excused from most out-of-pocket service costs.
Most people are automatically enrolled in Part A and B when they turn 65. You can also contact your local social security office to qualify your eligibility.Call your state’s Medicaid office to see if you qualify. Eligibility depends on the rules of your state.

Navigating these programs can be daunting. If you are overwhelmed by all the information, try talking to your physician or insurance agent. There are resources available that help seniors understand their entitlements, such as AARP. You can also contact your local social security office for more details on your Medicaid or Medicare eligibility.

*Source: Medicare Made Clear