• Medicare vs. Medicaid: What is the difference?

Medicare and Medicaid two government-administered health care programs that

can be easily confused. This is usually the case as both programs sound alike
and both begin with the same four letters. However, the truth is, these two have
differences which are essential to know. Although they might sound alike, these
two programs have different requirements for eligibility. Together with the
differences in the cost and health care benefits.

Medicare and Medicaid are two separate programs that are run by the
government. These two programs were created back in 1965 because of the
increasing inability of older and lower-income Americans to afford private health
insurance. When it was created, it was a part of the “Great Society” vision of
President Lyndon Johnson. It aims a general social commitment to meet
individual social, economic, and health care needs of an American. This social
commitment is achieved by providing a social insurance program that shares
financial burdens among healthy and sick individuals. This sharing of financial
burden goes the same as affluent and lower income families.

To understand better the what these social insurance programs are and their
differences take a look at the following.

What is Medicare?

Medicare is a health insurance program that is available to U.S. citizens and

permanent legal residents of five years in a row or more who are age 65 or older.
Younger individuals may also avail of this health insurance program if they have
been a recipient of Social Security disability or Railroad Retirement Board
benefits for 24 consecutive months. Individuals below 65 years of age who are
suffering from certain health conditions may also avail of Medicare. This health
conditions covered by the Medicare are end-stage permanent kidney failure that
requires dialysis or a kidney transplant. Others are Lou Gehrig’s disease or
amyotrophic lateral sclerosis.

According to the Centers for Medicare & Medicaid Services, there are nearly 58
million Medicare applicants in America. In most cases, once an individual
becomes eligible they automatically get enrolled in Medicare Part A and B. The
coverage of Part A is a hospital and hospice care. While Part B cover services
such as medical care, preventive services, and durable medical equipment and
supplies. Part A Medicare can be premium-free in case the enrollee or his spouse
worked and paid for Medicare taxes for at least ten years. However, Part B,
unlike Part A, comes with a premium. Both Part A and B have deductibles and
copayment amounts set at the federal level. These amounts could change
annually.

Another way to avail of your Medicare benefits is Medicare Advantage or

Medicare Part C. This Medicare benefits comes from a private company. It
covers all of what the Original Medicare covers plus additional benefits that are
generally not included in the Original Medicare. This other benefits may include
dental care and routine vision. When you avail of Medicare Advantage, it is a
requirement that you must continue paying the monthly premium of Part B
Medicare. This kind of Medicare is not offered in all areas.

Part D Prescription Drug Plans or Stand-Alone Medicare cover certain

prescription drugs. These prescription medicines covered by Part D are not
typically covered under the Original Medicare. Also, just like Medicare
Advantage, Stand-Alone Prescription Drug Plans are offered by private, and
Medicare approved companies.

What is Medicaid?

Medicaid is a program jointly funded by the state and the federal government. It
aims to provide health care for low-income individuals and families. This program
can also help qualified enrollees with their medical costs and long-term custodial
care. The eligibility for Medicaid is determined by income together with the
requirements set by a state.

In some cases, the coverage of Medicaid and Medicare may overlap. This
includes insurance for hospital care and doctor’s services. Medicaid program
may also offer additional benefits such as routine dental care and routine vision
services and hearing aids that are not usually covered by Medicare. Also,
Medicaid generally supplies its beneficiaries prescription drug coverage, unlike
the Original Medicare Part A and Part B.

Unlike Medicare, in some states, Medicaid does not have federally set premiums,
deductible, and coinsurance. However, States are given the option to charge
premiums and set cost-sharing requirements for its Medicaid enrollees. The
State government is given the opportunity to charge higher individuals who are
receiving higher incomes. In addition to this, the State governments hold higher
control over Medicaid compared to the Medicare program.

Medicaid programs have seen to be providing significant assistance to children.

According to the Centers for Medicare & Medicaid Services, in the year 2015,
43% of the monthly Medicaid enrollees were children.

Can I qualify for both Medicare and Medicaid?

You may be eligible for both Medicare and Medicaid if you are low-income earner
with over 65 years of age, or you are a low-income person with a disability or is
suffering from the end-stage renal disease or amyotrophic lateral sclerosis.

At present, the Centers for Medicare and Medicaid Services and Medicare –
Medicaid Coordination Office are working hand in hand to coordinate benefits
between these two programs.

( If you have a question relating to Medicare and Medicaid, you can contact our
company by dialing _____.
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