Medicare vs Medicaid
Medicare vs Medicaid – What’s The Difference?
Medicare and Medicaid are separate programs that frequently get mixed up. Understanding the difference between the two will help you maximize your benefits as a beneficiary.
Medicare is the federal health insurance program for all individuals age 65 and older. Medicare eligibility is not dependent on income.
Medicaid operates as both a federal and state-level program to provide health care coverage to individuals with very little income. Eligibility for Medicaid depends on income level.
It is possible to qualify for both Medicare and Medicaid at the same time (dual coverage). Those who do receive benefits from both programs working to lower your health care cost.
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Medicare is federally run health insurance program for individuals age 65 and above. In 1972, new legislation expanded Medicare to cover individuals with disabilities and end-stage renal disease. Currently, 44 million Americans receive Medicare benefits.
- Medicare Part A – Hospital insurance (inpatient care)
- Medicare Part B – Doctors insurance (outpatient care)
- Medicare Part C – Medicare Advantage
- Medicare Part D – Prescription Drug
Original Medicare provides both Part A & Part B. While Part C and Part D provide ways to customize and expand your benefits.
All individuals eligible for Medicare can enroll in all four parts during one of the Medicare enrollment periods.
Medicare Advantage plans provide bundled comprehensive health insurance coverage. These are private insurance plans sold by private insurance carriers.
Medicare Supplemental Insurance – Within Original Medicare (part A & part B), there are several gaps in which medicare beneficiaries have out-of-pocket expenses in the form of deductibles, coinsurance, and copayments. Medicare supplements, also referred to as Medigap, fill in the financial gaps that loom inside of Original Medicare. There are ten different Medigap plans — each plan covering a different set of financial gaps.
Although Original Medicare provides excellent health care coverage, it’s far from complete. As a result, 8 out of 10 Medicare beneficiaries choose to enroll in either Medigap or Medicare Advantage. Our team of independent agents is here to help you customize your benefits.
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Medicaid is both a state and federally run health insurance program that provides coverage to low-income individuals. The Medicaid program differs between states. Each state determines financial guidelines that determine who is eligible for Medicaid benefits. The four main groups that Medicaid serves are:
- Seniors Citizens
- People with disabilities
Medicaid spend-down program – Various states across the country allow individuals to deduct their medical expenses from their income to qualify for Medicaid. Contact your local Medicaid office for more information.
All states allow for possible dual coverage for both Medicaid and Medicare.
Medicare vs Medicaid Next Steps
If you qualify for Medicare, Medicaid, or both, what should you do next?
If you have further Medicaid questions or need help submitting a Medicaid application, then you’ll need to contact your local Medicaid office. Independent insurance agents cannot assist you with this.
Individuals looking to explore their Medicare options can get started today by filling out the form on your screen.
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