• Harry N. Stout

276- Medicare vs. Medicaid: What’s the Difference?


Today’s post is from the contributing organization Medicare Advantage Plans and their team of writers.


Have you wondered about the difference between Medicare and Medicaid? They’re very different programs. Although both are government-run health care programs, the similarities end there. Medicaid is available if you have low income, while Medicare eligibility kicks in when you turn 65 or have a qualifying disability.


If you meet income eligibility, Medicaid can be an essential resource for covering health care expenses that Medicare does not. But not everyone can qualify for Medicaid, so you can enroll in Medicare when you reach retirement age.


Both programs are designed to offset the costs of health care services. Medicaid offers additional coverages that Medicare does not. If you’re “dual-eligible,” you can qualify for Medicaid and Medicare and get coverage from both.


Learn more about the differences between Medicaid and Medicare.

Is Medicare the Same Thing as Medicaid?

Although they sound similar, Medicare and Medicaid aren’t the same. The only similarity is that both government programs help cover health care costs for Americans.


Medicaid doesn’t have an age requirement, so adults of all ages and dependent children can enroll. In 2021, there were 75.4 million people covered with Medicaid. Medicaid plans are administered by the states but funded jointly by the state and federal government. Medicare is a federal program managed by the United States Centers for Medicare and Medicaid Services (CMS). The U.S. Social Security Administration (SSA) handles Medicare enrollment and premium payments. It has an age requirement (65) unless you’ve been on disability for 24 months or have specific medical conditions.


Which is Better, Medicare or Medicaid?

Both programs are crucial in helping Americans afford health care expenses. Medicaid is based on financial need and is more widely available for people of all ages. It also provides more complete coverage than Medicare, as it pays for some drugs and additional services such as nursing home care, personal care, dental, vision, and hearing. If you don’t meet your state’s Medicaid eligibility, Medicare is a significant government benefit if you qualify.


Can You Have Both Medicare and Medicaid?

In some cases, you can be eligible for both Medicaid and Medicare ― it’s referred to as “dual eligible.” With both Medicare and Medicaid coverage, the programs will cover practically all of your health expenses.


For dual eligibles, Medicare is the primary coverage and pays first. Medicaid pays second for anything that isn’t covered. Medicare can cover your Part D prescription drugs while Medicaid may cover some drugs and other care not covered by Medicare.


Some states have a Medicare-Medicaid Plan (MMP) which coordinates your Medicare and Medicaid benefits. Depending on your eligibility, you may qualify for a Dual Eligible Special Needs Plan (D-SNP) with some state-covered costs.


Is Medicaid Free?

It’s free to sign up for Medicaid, and coverage is typically free or low cost. If you have both Medicare and Medicaid, it’s possible to find a plan through a private insurance carrier with no premiums and little to no out-of-pocket expenses at the doctor.

 

To learn more about Medicare and find in-depth guides and resources to help you make educated health care decisions, visit Medicare Advantage Plans.

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