Medicare and Medicaid are two different programs that are meant to help people meet their healthcare needs. Both have a different eligibility process and may not cover the same services. Medicare pays for primary care, while Medicaid pays for copays and other expenses not covered by Medicare. If you are in between Medicaid and Medicare, you may qualify for a program called a Qualified Medicare Beneficiary (QMB). This program helps people pay their Part A and Part B premiums. In addition, it can cover some deductibles.
Medicaid is a government program for low-income individuals who have limited or no income. This program also covers certain disabled people and pregnant women. Both programs are available to individuals who meet the income requirements. Although the Medicare program covers those 65 and over, Medicaid covers those under a certain income level and is available for anyone with a disability. The difference between the two programs is that SSI does not cover dependents, while Medicaid will cover the costs of health insurance for a family member or dependent.
Original Medicare is managed by the federal government and covers hospitalization, medical services, supplemental coverage, and prescription drugs. It covers around 80% of health care costs, leaving the remaining 20% up to the individual. Part B also covers some outpatient surgeries, disease screenings, and flu shots. Late enrollment penalties may increase the cost of Part B.
Medicaid was established by the federal government through the Social Security Act in 1965. Its eligibility criteria are strict and varies greatly between states. It is the largest source of health care funding in the U.S. and serves millions of low-income individuals. As of November 2020, nearly 72 million people were enrolled in Medicaid. Medicaid also covers children under age 18 through the Children’s Health Insurance Program. However, it is important to remember that Medicaid is only available to those who are low-income or have a disability.
Some people qualify for both programs. They are called “dual eligibles.” They have low incomes and medical needs. Approximately 60 percent of dual eligibles have at least one chronic condition. Due to the Affordable Care Act, insurers have begun to offer specialized plans for these individuals.
Medicaid and Medicare are similar but have a few differences. Original Medicare covers the elderly and those with certain disabilities. Original Medicare offers prescription drug coverage and Medicare Advantage covers health care. Depending on the individual’s income, Medicaid can provide health coverage for an additional fee. This insurance covers prescription drugs and may also include dental and optometrist services. They can also cover physical therapy and prescriptions. These programs are different, but both have many benefits.
Original Medicare covers hospital care. It also offers coverage for parts B and D. However, some people may choose not to enroll in Part B. This option also includes an additional monthly premium. Medicare also reviews its plans on a 5-star rating system every year. If you don’t enroll in Medicare Part B, you may not be eligible for the premium give-back. If you do, however, want to reduce your monthly premiums, consider signing up for a Medicare Advantage plan.
Although both programs are similar, Medicaid offers more benefits. It covers a larger population of low-income individuals and provides broader coverage for services for older people. Some Medicaid programs also cover long-term care, such as nursing homes, assisted living facilities, and adult day care. If you qualify, both programs can be a valuable resource.