Medicare and Medicaid sound alike, and we know that causes some confusion: but the truth is that while these government programs provide basic healthcare benefits, they are dramatically different from one another. So let us break it down for you:
Medicare is a federal health insurance program for:
- Individuals who are 65 years of age or
- Have been receiving Social Security Disability Insurance for at least 24 months. There is an exception to this rule if you receive SSDI because you have Amyotrophic Lateral Sclerosis (ALS)
Medicare is funded through the taxes that are paid towards Social Security. It is designed to help with, but not completely cover, long term medical treatment. There are 4 parts to Medicare, with each providing a different level of coverage.
- Part A: This coverage includes hospitalization
- Part B: This covers doctor’s appointments and emergency room visits
- Part C: This type of plan called a Medicare Advantage plan. It is purchased through private insurance carriers who have contracts with Medicare. They are required to offer you the same coverage as Original Medicare (Part A and Part B) and may offer additional benefits such as vision, dental, or hearing. Many include prescription drug coverage.
- Part D: Prescription Drug Coverage. In all cases, like most health insurance, the patient may be responsible for some cost.
Medicaid is co-funded at the federal and state tax levels and is designed for those with low income or the most vulnerable among us. Medicaid provides coverage for older people, individuals who are disabled, and some families with children.
While Medicare has 4 different parts, Medicaid largely covers all of the primary types on medical care and treatments an individual requires. Each state runs its own Medicaid program under the guidance of the Centers of Medicare and Medicaid Services. And while it does not require paying taxes while working, it does have its own guidelines about how much income and resources you can have in order to qualify.
Each state has its own set of eligibility rules and guidelines and decides what services to cover. To find out more about your state’s Medicaid program you can visit https://www.medicaid.gov
There are Part C plans that may offer additional benefits to those who are Dual Eligible (meaning beneficiaries who have both Medicare and Medicaid).