Medicaid vs Medicare

Medicaid vs Medicare

Is there a difference between Medicaid and Medicare?

This a question that many consumers become easily confused about, and it’s absolutely understandable to get the two programs mixed up.

Medicare is the Federal health insurance program for seniors who are primarily over the age of 65, and those under 65 who have certain disabilities, such as kidney disease and require dialysis.

Medicaid on the other hand is a state run program (which financial assistance from the Federal Government) that provides medical care to many different types of Americans such as:

  •       The Undeserved
  •       Children
  •       Pregnant Women
  •       Those with serious health conditions

What do the two programs cost?

Medicare

  • Part A (Hospital Coverage) is primarily funded by payroll taxes. If you have     not earned enough credits to receive Part A at no cost (rare), you can “buy into” Medicare Part A.
  • Part B (Physician Services) – Most Medicare beneficiaries pay about $147/month in 2013.
  • Part D (Outpatient Drug Coverage) – This is optional coverage with rates averaging $40/month for a drug plan.

Medicaid
For most consumers, Medicaid will come at no cost, although there are “share of cost” programs, dependent on income, where an insured may be responsible to a small cost for medical services.

What do they cover?

Medicare

  • Part A – Hospital Expenses
  • Part B – Physician Charges and Outpatient Medical Expenses
  • Part D – Prescription Drugs with plans like this Transamerica MedicareRx

Medicaid
Medicaid covers a lot more medical services than does Medicare. Though each state determines what they will cover with their own Medicaid program, a few of the benefits that are routinely found within a Medicaid health plan is coverage for :
Assisted Living Facilities, Dental Treatments, Medicine, Hospital Stays, Maternity Expenses, Outpatient Treatments, Family Planning, etc.

Is it possible to be on both Medicare and Medicaid at the same time?
Yes, it is called being “Dual Eligible.”  The way this works usually is a Medicare Beneficiary happens to also qualify for Medicaid Benefits. You may ask yourself, how this is possible? A senior would need to be a Qualified Medicare Beneficiary, this when Medicaid pays for a portion or all of your Medicare-associated costs. This would include premiums and out-of-pocket expenses such as copayments, deductibles, and coinsurance. One of the neat things about this program is that Medicaid can cover drugs not covered by the Federal Medicare Part D program, among other benefits.

If you need any assistance in figuring out Medicare starts and Medicaid stops, just enter your zip code in the box above to be presented with various local resources that can assist you with all of your Medicare insurance needs, such as Dual Eligible Medicare Advantage Plans.

4 Comments

  1. I discovered that my insurance has a high debuctable which which EPIC does not cover so I can not afford my meds. This has caused eye problems and regular eye injectimeds.I have been diagnosed with Ocular Hypertenson and. Suffered retina stroke which needed laser surgery.Is there a solution to my problem. I have Empire MediBlue Plus (HMO)

    Reply
  2. I am not interested in any plan involving hmo doctors. My doctor is a ppo n i refuse to lose him with an hmo plan.

    Reply
  3. How can I enroll in the dual eligible benefit (medicare and Medicaid)
    programme.

    Reply
    • Each state has different rules about eligibility and applying for Medicaid. Call your state Medicaid program to see if you qualify and learn how to apply.

      Reply

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