Medicare vs. Medicaid: What’s the difference?

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Health coverage is a primary concern for many senior adults and for a good reason. Because there is a great need for health coverage for senior adults, many of them rely on Medicare, Medicaid, or both coverages to help with medical costs. 

According to the CDC, over 21% of seniors are in fair or poor health. Much of that percentage has chronic ailments. These health issues that cause them to need more involved or long-term care options later in life.

Medicare and Medicaid are two separate government-run programs. Unfortunately, many people use them interchangeably in conversation, even though the differences are significant. Not only are they funded by different parts of the government, but they also provide coverage and support to different groups of Americans.

 

What is Medicare?

Medicare is a federal program that provides health coverage to seniors. In addition to those over 65 years old, it also provides health coverage to those who are under 65. These applicants might have a disability or an End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). 

Medicare is divided into three parts (Part A, Part B, and Part D), based on services needed: 

  • Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Part D adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare private-fee-for-service plans, and Medicare Medical Savings Account plans. 

 

What is Medicaid?

Medicaid, on the other hand, is a federal and state program that provides health insurance coverage to low-income individuals. The states administer Medicaid, according to federal requirements. 

You must qualify for Medicaid since it is considered a public assistance program. Medicare is guaranteed coverage for specific groups of people. 

 

Can I be eligible for both?


If an individual meets qualifications for both, they can receive coverage from both programs. Though most states have specific eligibility requirements, millions of Americans qualify for dual-enrollment. 

According to Medicaid.gov, 7.2 million low-income seniors are enrolled in both Medicaid and Medicare. Many of these seniors require long term care or are in a nursing home or assisted living facility. 

 

Are there any other significant differences?


While Medicare and Medicaid are both health insurance programs that the government administers, there are differences in covered services and cost-sharing. 

While Medicare is an insurance program, Medicaid is an assistance program. Medicaid covers more than just seniors or those with disabilities. Many pregnant women and children also receive coverage through Medicaid. 

Another important difference is that because Medicaid is a federal program, it is similar no matter in which state you live. Medicare, on the other hand, has income and eligibility requirements that can vary by state. 

 

What resources are available to help me learn more?


Call 1-800-MEDICARE or contact your local Medicaid office to learn more about Medicare and Medicaid costs and coverage, especially if you are a dual-eligible.

If you have any questions about what our long-term facilities accept, Medicare or Medicaid, please feel free to reach out to us using the contact form below. We would love to talk with you about your long-term care needs and ensure your loved ones receive the healthcare they deserve. 

 

 Learn more about assisted living and skilled nursing care with USA Healthcare, and Woodland Haus Assisted Living, located in Cullman, Alabama, offers planned nursing care based on each of their residents’ individual needs and abilities, with the goal of achieving an optimal quality of life. Contact us today for more information or to set up an appointment with someone on our team. 256-739-2988   address: 1900 Olive Street Cullman, Alabama 35055

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