The words “Medicare” and “Medicaid” are so similar that it’s easy to get confused. Both are government programs to help people pay for health care to add to the confusion. But that’s where the similarities end.
Below is more information about each program and the comparison points.
What is Medicare? What is Medicaid?
Medicare is a federal program generally for people aged 65 or older or who have a qualifying medical condition or disability. The federal government provides Medicare Part A, and Part BThe federal government provides Medicare Part A and Part B, and Medicare Part C and Part D. However, run by the federal government are provided by private insurance companies.
Medicaid is a state government program that helps pay health care costs for people with limited income and resources, and there are different programs for specific populations. Medicaid plans vary from state to state but follow federal guidelines for benefits.
What do Medicare and Medicaid cover?
Medicare Part A is hospital insurance, and Part B is medical insurance. Medicare Part D is prescription drug coverage, and Part C (Medicare Advantage) is an all-in-one coverage option that combines Parts A, B, and D and other benefits that could include dental, vision, hearing, and physical conditioning. Medicare Part A and Part B coverage are standard, but Part C and Part D vary based on the coverage conditions provided by the plan, insurance provider, and location.
Medicaid programs include federally mandated benefits and optional benefits. Each state decides which optional benefits to having.
How Much Does Medicaid Cost? How Much Does Medicare Cost?
Both Medicare and Medicaid may include premiums, deductibles, copays, and coinsurance. For Medicare, what you pay will vary depending on when you sign up, what coverage options you choose, and what health services and items you use during the year. For Medicaid, the amount you pay will depend on your income and the rules in your specific state. Also, some particular groups that have Medicaid are exempt from many out-of-pocket costs.
There are also four different Medicare Savings Programs designed to help with the cost of Medicare. If you qualify for one of these programs, you may be able to get help paying your Medicare premiums and, in some cases, help to pay your Medicare Part A and Part B deductibles, coinsurance, and copayments.
Can You Have Both Medicare and Medicaid?
Yes, some people may have both Medicare and Medicaid. People who qualify for both Medicare and Medicaid are “dual eligible.” If you are eligible and choose to enroll in both programs, the two can work together to help you cover most of your health care costs. You may also qualify for a special kind of Medicare Advantage plan called a Dual Eligible Special Needs Plan.
How to get Medicare
To get Medicare Part A and Part B, you’ll have to sign up directly with Social Security. The exception to this rule is if you are receiving Social Security or Railroad Retirement Board benefits when you become eligible for Medicare, usually at age 65. In this case, you will be automatically enrolled in Medicare Parts A and B. To get Medicare Part C and Part D, you’ll need to sign up directly with the private insurance company that offers the plan you want.
How to get Medicaid
The requirements to enroll in Medicaid depend on the rules in your state. To find out if you qualify and to begin enrollment, contact your State Medical Assistance (Medicaid) office. You can visit www.medicare.gov to find a local office and learn more about Medicaid eligibility and enrollment.
Medicare and Medicaid are two very different healthcare programs, so it’s essential to understand the differences between them and how they can work together for your benefit if you have dual eligibility.