MediCARE vs MedicAID

It's so easy to interchange the words Medicare and Medicaid isn't it? They're both insurances and come from the government. So, what's the difference?

 It DOES make a difference when discussing these government programs as they have very distinct rules and benefits.  Let's take a look at what they are.


MEDICARE

  • Federal program: Funded and operated by the federal government.

  • Eligibility: Primarily for people aged 65 and older, but also available to younger people with certain disabilities or those with End-Stage Renal Disease (ESRD).

  • Coverage: Helps cover hospital stays (Part A), medical services like doctor visits (Part B), and prescription drugs (Part D).

  • Cost: Generally involves premiums, deductibles, and co-pays.

 

Certain disabilities qualify individuals for Medicare before the age of 65. These include:

  • Social Security Disability Insurance (SSDI) Recipients

  • Amyotrophic Lateral Sclerosis (ALS) (also known as Lou Gehrig's disease)

  • End-Stage Renal Disease (ESRD)

See Centers for Medicare and Medicaid for further descriptions.

MEDICAID

  • State and federal program: Jointly funded by federal and state governments but managed by states.

  • Eligibility: For low-income individuals and families, including children, pregnant women, elderly, and people with disabilities. Income level is the key determinant.

  • Coverage: Offers comprehensive coverage, including hospital stays, doctor visits, long-term care, and sometimes prescription drugs.

  • Cost: Typically little to no cost to the patient


You can have both Medicare and Medicaid. If you qualify for both, Medicare typically pays first, and Medicaid can cover additional costs, like premiums and out-of-pocket expenses.

If you feel you may qualify for either or both and need help walking through the system, give me a call and I will walk through it with you.

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