What is the difference between Medicaid and Medicare?

What is the difference between Medicaid and Medicare?

Many individuals and families are living without health insurance in America, which has led to the popularity of Medicaid and Medicare.

When it comes to Medicaid vs Medicare, some people looking for health care assistance fail to realize the difference between the two programs. Although both programs are federally funded, they are typically available to two separate groups of people.

Medicaid is a state-run health insurance program available to eligible low-income people, seniors, people with specific disabilities and families with dependent children.

The specific eligibility requirements for Medicaid vary per state, but the general requirements are based on financial need. The specific services offered under the Medicaid program are also determined at the state level. The federal government has established a list of services that all states must offer to Medicaid recipients.

Some of the mandatory services offered under the Medicaid program include inpatient and outpatient hospital care, physician and midwife services, prenatal services, pediatric care, x-rays and laboratory testing and vaccines for kids. Optional services offered in some states include chiropractic, dental, private duty and physical therapy services.

Understanding the Four Parts of Medicare

Medicare is a health insurance program funded by the federal government that is available to people over age 65, younger individuals with certain disabilities and individuals diagnosed with End-Stage Renal Disease.

Medicare has four parts – Part A, Part B, Part C and Part D. Each part has its own features. Most individuals meeting eligibility requirements receive Part A at no cost. Those who do not qualify for free coverage can purchase Part A. Individuals electing to receive the other three Medicare parts must pay a monthly premium.

Medicare Part A is considered hospital insurance and covers inpatient hospital visits, hospice care and skilled-nursing facilities.

Medicare Part B is considered medical insurance and covers services not offered under part A, such as outpatient visits, physical therapy services and occupational health therapy services.

Medicare Part C is commonly referred to as Medicare Advantage. Part C is purchased through private health insurance companies. Most people who purchase Part C desire to receive additional coverage of services offered under Parts A and B. Most Medicare Advantage plans also cover the purchase of prescription drugs.

Medicare Part D is a prescription drug plan, which helps to lower the cost of prescription drugs and may protect against rising costs of medicines.

Qualifying for Both Medicaid and Medicare

Comparing Medicaid vs Medicare is extremely important to understanding the health care insurance you may qualify to receive. Some individuals with a extremely low household income may qualify for Medicaid and Medicare. In that case, most medical and prescription drug needs are covered without having to purchase additional health insurance coverage.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

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