Medicare and Medicaid are two government health care programs. Many confuse the two. However, it’s important to know the difference. Medicare is a federal program available to all seniors who are 65 or older. On the other hand, Medicaid is jointly funded at state and federal levels and is usually intended for lower-income families and individuals.
We’ll take a deeper look into both of the programs, the eligibility requirements for both, and if you could benefit from either.
What is Medicare?
Medicare is the federal program that provides health insurance to adults over 65 years of age. Most people who have paid Medicare taxes while working are automatically enrolled in Medicare when they turn 65. This usually means that you have worked at least 10 years, or 40 quarters in the United States. If you did not work for this long, you could potentially be eligible for Medicare through your spouse.
Medicare covers all of your basic health insurance needs. It breaks down into Parts A through D. Medicare Part A is your hospital insurance. It covers your hospital stays and any of the services associated with medically necessary needs at a hospital. Part B covers your outpatient needs. This includes doctor visits or routine screenings. Part C is also known as Medicare Advantage. Beneficiaries with Medicare Advantage get all of the benefits of Parts A and B, with some limitations to the network. Finally, Part D is prescription drug coverage. If you take any prescription drugs, it is important to have Part D coverage to make sure you are covered for all of your medications.
While Medicare covers most of your medical needs, there are some gaps in coverage. A Medicare supplement plan can fill these gaps. These gaps include a portion of the Medicare costs. Medicare pays for 80% of all Medical expenses, leaving the patient responsible for the remaining 20%. Medicare supplement plans can cover these costs. Additionally, Medicare supplement plans can cover all deductibles, coinsurance, and copayments associated with your Medicare coverage.
Medicare does not offer coverage for dental, vision, or hearing. For these services, you will need additional dental, vision, or hearing coverage.
What is Medicaid?
Medicaid is best described as an assistance program. Unlike Medicare, both state and federal governments fund Medicaid. Usually, Medicaid aids low-income people or families. Medicaid serves people of all ages, regardless of background.
Requirements for eligibility of Medicaid varies by state. Your income levels also help determine your Medicaid eligibility. Some seniors are eligible for Medicaid, but first must meet the requirements. These requirements include the ability to pass a medical necessity test, an asset test, and an income test.
Medicaid might offer certain benefits that Medicare does not offer, such as routine dental, vision, and hearing care. Medicaid also provides prescription drug coverage to its beneficiaries. You would not have to purchase any additional plans.
If you believe you might be eligible for Medicaid, you can check your eligibility by going on the Medicaid website.
What’s the Difference Between Medicare and Medicaid?
As mentioned, Medicaid offers some benefits that Medicare does not offer, and vice versa. For example, Medicaid offers dental and hearing coverage while Medicare does not. However, Medicare does not have income limits for eligibility, making it easier for any qualified senior to get coverage. The chart below outlines the major differences between Medicare and Medicaid.
Can You Have Medicare and Medicaid?
It is possible to have both Medicare and Medicaid. This is dual-eligibility. Individuals who are dual-eligible are usually adults over 65 with a low-income, or a low-income person with a disability such as End-Stage Renal Disease or ALS.
If you are dual-eligible for Medicare and Medicaid, the Centers for Medicare & Medicaid Services (CMS) collaborate to make sure your benefits from each program work together. The CMS has an extensive collection of resources for people who are dual-eligible who have questions about coordinating their benefits.
How GoMedigap Can Help
Do you have questions regarding the differences between Medicare and Medicaid? Do you believe you might be dual-eligible and want to check on your benefits? We can help. Contact one of our friendly, knowledgeable agents, and we can help explains the similarities, differences, and the benefits you get from these health programs.
Additionally, if you have Medicare and are looking to fill the gaps in your coverage, we can help you enroll in a Medicare supplement plan. You can get your free quote online or give us a call at (800) 310-2550.