What is the Difference Between Medicare vs. Medicaid?

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Your health is always an important aspect, but it becomes increasingly important as you age. When you turn 65, you’ll have the option of finding the ideal health plan after your employer’s insurance ends. The good thing is there are two options: Medicare and Medicaid.

Unfortunately, there is a lot of confusion surrounding the two plans. While you can have both of them if you’re eligible, it’s still vital to understand their differences.

What is Medicare?

Medicare is a federal health insurance program that covers people who are 65 or older. It also covers some people under 65 with a disability. The program has parts A, B, C, and D, each with unique requirements. It helps millions of seniors and disabled individuals cover some of their health care costs.

The program is available to the individuals below:

  • Age 65 or older
  • Disabled
  • End-Stage Renal Disease (ESRD)

The level of coverage depends on which part you’re eligible for. For example, Part A covers surgery, inpatient hospital stays, hospice care, and stays in skilled nursing facilities. Part B covers outpatient care, doctor’s visits, some medical supplies and equipment, and some preventive services.

Parts C and D are offered by private insurance companies, which must adhere to Medicare requirements. Part C combines A and B into one plan, and it includes prescription drugs, while Part D provides coverage for prescription drugs.

When your time comes to enroll in Medicare, you have several options. For some people, enrollment is automatic when they turn 65. For others, it depends on how and when they became eligible.

What is Medicaid?

Medicaid is a federal and state health program for people with limited resources and income (incomes of up to 138 percent of the poverty line). Unlike Medicare, Medicaid serves people of all ages. While people don’t pay for covered medical expenses, the program might require a small co-payment in some cases.

The eligibility of Medicaid mostly depends on your income. There are tools available to check your eligibility. You must also be a resident in the state you’re applying for Medicaid and a citizen of the United States. Medicaid typically covers pregnant women, children, low-income adults, seniors, and people with disabilities.

Medicaid has several benefits, including physician services, inpatient and outpatient services, laboratory and x-ray services. There are also optional benefits, such as physical therapy, case management, occupational therapy, and prescription drugs.

Medicaid doesn’t have open enrollment periods, so you can apply any time of the year. However, it is important to become informed before you enroll.

Major Differences

It can be easy to confuse Medicare and Medicaid as they are both government assistance and have almost the same name. The main difference between the two is the age requirement and financial eligibility. Medicare only covers those who are 65 or older. However, those with a disability and ESRD are an exception. Medicaid covers all people with limited income, regardless of their age.

Also, the federal government governs Medicare while state governments govern Medicaid. Medicaid is more personalized to offer different programs under one umbrella that are tailored to specific populations.

Regardless of the differences, you can be eligible for both Medicare and Medicaid. This is possible if you’re 65 years or older and you meet your state requirements for Medicaid.

Coverage Options

No matter which option you go with, it’s vital to under the different coverage options and the programs and parts they offer. Bear in mind both Medicaid and Medicare may include copays, premiums, deductibles, and coinsurance.

When comparing the two, it’s vital to take the time to learn more about Medicare vs. Medicaid and Medicare coverage. Be sure to check each program’s eligibility requirements while taking into account your age and income level.

Understand Your Options

Medicare and Medicaid can be quite helpful in the event your medical bills start to climb or your income changes. Whether you have a limited income or you’re 65 or older, opting for the most suitable plan is important—this is particularly vital when comparing Medicare parts. Be sure to consider your current health needs and income. Still, you can qualify for both options, allowing you to enjoy the best of what each has to offer.

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