A common misconception is that many people assume Medicaid & Medicare are the same thing. While they share similarities, they both serve different purposes and are meant for different situations.
The way both programs are presented can be very confusing, so let’s get clear on Medicare and Medicaid by going through two major differences.
Difference 1: Eligibility and Coverage
One of the most significant differences between Medicare and Medicaid is their eligibility and coverage.
Medicare primarily serves individuals aged 65 and older and certain individuals with disabilities or specific medical conditions.
It consists of different parts that cover hospital coverage, coverage with doctors & their services, prescription drugs, and things of that nature. Regardless of income, those who qualify for Medicare can enroll once eligible.
Medicaid is a state-administered program that offers healthcare coverage to individuals and families with limited income and resources.
Eligibility varies by state and includes low-income adults, children, pregnant women, and individuals with disabilities. It covers a range of medical services, including hospital stays, doctor visits, preventive care, and long-term care services.
Difference 2: Cost and Benefits
Medicare is known for its many coverage letters and its associated costs. For example, Medicare Part B, which covers your doctor’s visits, has set premiums based on income and changes yearly. There are other letters like Part A, Part C (Medicare Advantage), and Part D, which have different costs based on need and coverage.
Additionally, many opt for supplemental insurance (Medigap) or Medicare Advantage plans to help cover the costs that Medicare doesn’t.
For most states, Medicaid typically doesn’t charge premiums for most beneficiaries. You will want to contact their offices directly to get a full breakdown of Medicaid coverage based on your state.
Medicaid also provides more benefits, like long-term care and coverage for dental care and eyeglasses, which Medicare does not cover. However, Medicaid recipients are not eligible for Medigap.
While Medicare serves those 65 and over and specific individuals with disabilities, Medicaid provides coverage for low-income individuals and families.
Please note that if you are “dual-eligible” for Medicare & Medicaid at 65, you will still want to enroll in Medicare Parts A & B.
Medicare is complicated, but it doesn’t have to be. The Medicare Coach is an unbiased Medicare expert not associated with any insurance company, agent, or broker.
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