Medicare Vs. Medicaid: What’s the Difference?

Naturally, some people confuse Medicare and Medicaid. After all, these two large government health insurance programs have names that sound somewhat similar. In addition, CMS says that over twelve million Americans qualify for both programs. Together, they help over 100 million Americans access medical care. To understand Medicare and Medicaid, take a moment to read this brief comparison.

Compare Medicare Vs. Medicaid

Since so many people rely upon these programs to access healthcare, everybody should have some understanding of the differences between them.

What is Medicare?

Some younger people qualify for Medicare because of a disability. Typically, most Americans will get Medicare benefits when they turn 65 years old, regardless of current income or health status. Most Medicare beneficiaries also get Medicare Part A for free but have to pay a premium for Part B. Since the federal government runs Medicare, it’s exactly the same everywhere in the United States.

Medicare provides fairly broad coverage for medical care, equipment, and services; however, beneficiaries may still need to pay for deductibles and copayments and things Medicare doesn’t help pay for. As one example, Medicare also doesn’t cover most prescription medication.

Most people enhance their Medicare benefits with a Medicare Part D drug plan for prescriptions. They may also choose either a Medicare Advantage or Medicare supplement plan to reduce out-of-pocket expenses.

What is Medicaid?

Medicaid serves low-income Americans as a healthcare assistance program. Since states partner with the federal government to run Medicaid, it can differ quite a bit from one state to another. Most of the time, Medicaid recipients don’t have to pay anything for covered services from participating providers; though, sometimes, they need to contribute modest copays. Recipients usually access Medicare benefits through an approved managed care plan.

Who Qualifies for Both Medicare and Medicaid?

Often called dual-eligible beneficiaries, most people who qualify for both Medicare and Medicaid are at least 65 years old and have low incomes, though some are younger and disabled. According to the Kaiser Family Foundation, about 43 percent of all spending on long-term care facilities comes from Medicaid, since Medicare only covers short-term stays under certain circumstances.

Most people who qualify for Medicaid are children, elderly, or disabled. Qualification for younger adults with low incomes but without a disability varies by state.

Some private insurers offer special Medicare Advantage plans for dual-eligible Medicare and Medicaid recipients. As with Medicare Advantage plans designed just for Medicare recipients, these plans may offer some benefits that Medicaid doesn’t cover, like assistance with transportation and over-the-counter medications.

Do You Need Help Finding Affordable Health Insurance?

Finding high-quality and affordable health insurance still presents a challenge for many Americans. Here at The Insurance Hub, our agents have experience working with people who have a variety of different healthcare needs and budgets, including children, younger adults, and seniors. You can call or email us today to schedule a free consultation.

Similar Posts