What is Medicare Compared to Medicaid?
They Are Different, But How?
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Getting to Know Medicare & Medicaid
Medicare and Medicaid are both government health insurance programs that provide coverage to people with limited financial resources. The differences may seem slight at first, but they can be significant for beneficiaries. So make sure to take the time to review options and how they apply to your own personal situation. Or, ask us to help! You can reach us during the week, for free, at (888) 352-6672 and we’ll make sure you’re comfortable with a plan tailored just for you.
What is Medicare?
Medicare is a federal health insurance program that provides people 65 and older with an affordable way to get coverage. It also covers many younger adults under certain conditions who may have disabilities or end-stage renal disease (ESRD). But the specific options can be numerous and your options may significantly impact the cost and coverage you end up getting.
What Does Medicare Cover?
It provides:
- Health care coverage for people who are 65 or older
- Certain younger people with disabilities
- Individuals with End-Stage Renal Disease (ESRD)
Medicare Primarily Covers the Following
Hospital care, including inpatient hospital stays and outpatient services such as emergency department visits. Medical equipment and supplies that a doctor/physician has ordered to get used at home under a durable medical equipment benefit for treating an illness or injury.
Some items have lifetime limits on their coverage. Medicare Part B also provides some preventive healthcare benefits, such as screenings for breast cancer, colonoscopies, and flu shots, without having to pay coinsurance from your pocket each time you get one. The only cost-sharing is usually 20% for approved medical and surgical procedures (the Part B deductible).
Who is Eligible for Medicare?
Eligibility for both types of insurance is based on age, disability status, and state of residence.
Medicare is available to people 65 years old or older, regardless of income or medical history.
Eligibility for Medicaid depends on the applicant’s income level; however, some exceptions under which individuals can become eligible even if they do not meet specific income requirements.
What Are the Benefits of Medicare?
As a program that covers seniors, Medicare is known for providing affordable health insurance. This significant benefit is an essential part of the United States healthcare system. It offers many options for people who might not otherwise be able to afford medical treatment or medication.
Medicare has many benefits compared to Medicaid, but the most important one is that Medicare provides more choices for consumers.
What Are the Costs of Medicare?
Medicare’s monthly premium can range from $0-$104, depending on how much coverage you need. On average, Medicare Part B will cover 80% of all medical services while 20% are paid out-of-pocket by the senior citizen under the plan.
People paying more than their expected share may be eligible for Medicare Extra Help through Social Security which pays 100 percent of prescription drug premiums and deductibles each month if they meet eligibility requirements. There is no monthly premium for Part D, but there can be penalties. Give us a call to discuss, or learn more about how to avoid the Part D penalty yourself.
What is Medicaid?
Medicaid is a federal program that provides health insurance for low-income individuals. It was created under Title XIX of the Social Security Act in 1965, but it did not offer coverage to children until 1988.
Medicaid has undergone several changes since its inception, including expansion and streamlining of eligibility requirements and increased benefits to recipients.
What Does Medicaid Cover?
Medicaid covers a wide range of health care needs. For example, the program covers doctor visits, hospital stays, lab tests, and prescription drugs for low-income or disabled. Medicaid also provides long-term services like nursing home care and personal assistance at home through a Medicaid HCBS waiver.
Who is Eligible for Medicaid?
Medicaid is a healthcare program that can help those who need financial assistance. Eligibility for Medicaid varies by state, but generally, it is available to low-income individuals, pregnant families and people with disabilities.
What Are the Benefits of Medicaid?
The benefits of Medicaid are that it has a meager cost to the consumer and offers many free services. Another advantage is that there is no income requirement for you to qualify, unlike Medicare which requires an individual who wants insurance under this program must be at least 65 years old or disabled and earn less than $85000 per year.
What Are the Costs of Medicaid?
The costs of Medicaid vary by state and depend on the person’s income. Eligibility for Medicaid typically depends on a family’s yearly earnings and assets, such as savings accounts or homeownership.
When an individual applies for Medicaid, they will need to provide proof of household income and size to determine eligibility. The monthly premiums vary based on the number of people in your household and total net worth, so you must fill out all documents correctly upon applying.
How Can You Apply for Medicare and Medicaid?
For one to apply for Medicare, one must be 65 years old. Once you are at least 65 years of age and have received social security benefits for a certain period, you can apply for Medicare coverage.
The requirements to receive Medicaid vary by state. Still, generally, it is an income-based program that helps with medical costs for low-income adults or children who do not qualify for other insurance programs.
Therefore, the amount paid out will depend on the individual’s income level and family size. Additionally, asset limits are often in place when determining eligibility levels, resulting in someone being disqualified from the plan if their assets exceed these limits.
From the above discussion, you can see that there is a significant difference between Medicare and Medicaid. It is up to you to conduct more research and decide on the best one.
Compare Today!
A licensed insurance agent from our team will contact you to discuss your Medicare options.
