Medicare versus medicaidMedicare Versus Medicaid

Many people confuse Medicare and Medicaid. Though they both help cover medical expenses, they are two very different government programs. In this article, we will compare Medicare versus Medicaid. We will go over what they cover and how to qualify for one or both.

Medicare

Medicare is for people over the age of 65 of those with a qualifying disability. If you pay Medicare taxes on your earnings you are automatically qualified to enroll at age 65, regardless of your income. Medicare consists of 4 parts. These include:

  • Part A: This part covers hospitalization. Typically, there is no premium for this coverage
  • Part B: Part B covers doctor services. You are responsible for a monthly premium and a 20% co-pay for all services.
  • Part C: This part refers to Medicare Advantage Plans. These are provided by private insurance companies to help fill gaps in Part A and B coverage. They typically also provide coverage for medication. If you choose a Part C plan you will still be responsible for your Part B premium in addition to the Part C premium. But some plans have monthly premiums as low as $0 a month.
  • Part D: Part D is stand-alone prescription drug coverage from private insurance companies. With a Part D plan, you will be responsible for a premium in addition to your Part B premium.
  • Medi-Gap: This is an additional type of coverage provided by private insurance companies. These plans are designed to cover gaps in traditional Medicare coverage. There are 10 standardized medi-gap plans. If you choose one you will be responsible for the medi-gap premium in addition to your Part B premium.

For an in-depth explanation of each part of Medicare click here.

Medicaid

Medicaid is a public assistance program provided to those in low-income brackets. Qualification is based on the federal poverty level. Medicaid cover is provided by the state that you live in. The exact benefits that you will receive will vary from state to state. Typically, Medicaid covers hospital services, nursing home care, home health care, labs, x-rays, and transportation to medical facilities. It may also cover prescriptions, physical and/or occupation therapy, optometry, and dental care. You can find out if you qualify by going through the questionnaire on healthcare.gov.

Qualifying for Both

In some situations, you are able to qualify for both Medicare and Medicaid. This is referred to as dual eligibility. In these cases, Medicare will cover your main expenses and Medicaid will fill in the gaps of coverage, including Part D Prescription Drug coverage. Again, you can find out if you qualify by going through the questionnaire on healthcare.gov.

Conclusion

Medicare and Medicaid are two very different services. But they both provide valuable benefits to the community. If you think you may qualify for one or both of them, take the time to do your research and apply. This way you are able to take advantage of their benefits.

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