Table of Contents
- Difference Between Medicare and Medicaid
- How Medicaid and Medicare Are Alike
- What Is Medicaid?
- Who Qualifies for Medicaid?
- What Does Medicaid Cover?
- What Is Medicare?
- The Different Parts of Medicare
- Do You Have More Questions About the Difference Between Medicare and Medicaid?
Many people become confused when searching for options to pay for their health care. Often, people don’t understand the difference between Medicare and Medicaid.
Difference Between Medicare and Medicaid
While the two serve the same essential purpose, they’re two very different programs. In certain situations, it’s even possible to qualify for both.
Continue reading to learn the difference between Medicare and Medicaid, as well as who is eligible for each program.
How Medicaid and Medicare Are Alike
It’s important to note the reason for the confusion between Medicaid and Medicare. Both are programs designed to help certain people pay for general healthcare and medical expenses. Who qualifies for these programs and what coverage they offer are what differ dramatically and difference between medicare and medicaid.
What Is Medicaid?
Medicaid is a public assistance program funded by both the federal government and individual state governments. The program is based on financial need and funded through income taxes.
The way Medicaid works can vary from state to state. Specific federal guidelines set minimum limits as to what the program must cover. Each state is allowed to expand coverage to include other healthcare costs.
Who Qualifies for Medicaid?
Medicaid is primarily available to low-income individuals who can’t afford traditional health insurance options. Besides meeting income restrictions, the following people may also qualify for the program:
- Women who are pregnant
- Minors and their parents (parent coverage is based on minor’s age and varies by state)
- Teenagers living alone or in group facilities
- People who are over the age of 65
- The legally blind
- Individuals who are legally and permanently disabled
Other individuals may qualify. Some states have expanded their programs to allow some individuals to be eligible for Medicaid, who wouldn’t be under federal guidelines.
What Are the Income Restrictions?
The income restrictions vary by state. Total income counts any earned wages, as well as certain countable assets. Federal guidelines don’t allow homes or vehicles to count towards total difference between Medicare and Medicaid asset amounts.
What Does Medicaid Cover?
Medicaid covers a wide range of services. Per federal guidelines, the program covers:
- Hospital services (both inpatient and outpatient)
- Nursing homes
- Home health care
- Labs and diagnostic imaging
- Transportation to and from medical facilities
- Tobacco-cessation counseling for pregnant women
- Primary care visits
- Custodial care
For some states (or specific populations), the Medicaid program has been expanded to include some or all the following:
- Prescription drug coverage
- Physical therapy
- Occupational therapy
- Dental Care
- Chiropractic care
People who are over the age of 65 and aren’t sure what their state covers can discuss it with Medicaid planning attorneys. These legal professionals can assist with certain other financial planning matters as well.
Countable Assets of Medicaid
If you don’t currently qualify for Medicaid because of your countable assets, a Medicaid attorney can also help you “down spend,” so you do. “Down spending” refers to a process where you legally transfer assets or get rid of them, so you qualify for Medicaid coverage.
The process of “down spending” isn’t right for everyone. It’s generally appropriate for people who are barely above the income limits for their state. This is why you should speak to a planning attorney, as they can help you understand your best option.
What Is Medicare?
Medicare is essentially a health insurance policy for senior citizens, meaning those over age 65. It’s paid for with a Medicare tax that is automatically withdrawn from the average worker’s paycheck. Unlike Medicaid, this is not an income-based program.
Who Qualifies for Medicare?
There are only two ways to qualify for Medicare. The primary qualification is being an individual over 65 who has paid into the program with their paychecks. You can also be eligible at an earlier age if you have certain permanent disabilities.
Medicare isn’t income-based. As long as a person paid into the program, they can receive health insurance. In some situations, a person over the age of 65 may qualify for both Medicare and Medicaid.
The Different Parts of Medicare
The Medicare program is split into four different parts. This includes parts A, B, C, and D. Each part of the Medicare program covers something difference between Medicare and Medicaid.
Certain parts of Medicare are free, while overs have premiums. The coverage offered by each of the four parts is discussed in more detail below.
Medicare Part A covers hospital care. There is usually a deductible that must be met before hospital care is covered. For people of a certain age, the cost of hospital care can quickly become a substantial burden.
Medicare Part B essentially covers things done to you. This might include doctors appointments, medical testing, and certain procedures. In some cases, Part B will also cover necessary medical difference between Medicare and Medicaid equipment.
Part C is an alternative to traditional Medicaid coverage offered through private insurance companies. It often includes all three other parts (A, B, and D). Sometimes it also provides other services, like dental care, vision, and hearing.
Part D is also offered by private insurance companies. Unlike Part C, however, Part D is not an alternative. Everyone is required to carry it unless an alternative source covers them.
Part D deals only with prescription drug coverage. It doesn’t cover all prescription drugs, however.
Many seniors with daily medications try to get coverage through both difference between Medicare and Medicaid. Each program covers certain medications and can be used together for prescription drugs.
Do You Have More Questions About the Difference Between Medicare and Medicaid?
Although they serve the same essential purpose, Medicaid and Medicare are two different programs. Certain people may be eligible for coverage through both programs.
Do you have more questions about the difference between Medicare and Medicaid?
Check out our other blog posts. You’ll find a wealth of information on closely related topics.