Medicare vs Medicaid: Do You Know The Difference?
By CarePatrol of Baltimore
If you’re not sure what the distinction is between Medicare and Medicaid, you’re certainly not alone. While both are government programs that help pay for healthcare, the cost, benefits and eligibility requirements are often very different. Below is a summary of each programs benefits. Also, see what happens when you can qualify for both.
Medicare is a federally funded program offered to most U.S. citizens and permanent legal residents who have lived in the country for five years or more. Participants must be age 65 or older. If under that age, you can still qualify if you’ve received 24 month of Social Security disability benefits from the Railroad Retirement Board (RRB), have permanent kidney failure and need routine dialysis (or a kidney transplant), or have Lou Gehrig’s disease (amyotrophic lateral sclerosis). Because these specifications are rare, most recipients are seniors.
Medicare Part A is a free program that covers most medically necessary services and supplies. Generally, it covers hospital care, skilled nursing and nursing home care, hospice, and home health services. To qualify, you or your spouse must have worked at least 10 years and paid Medicare payroll taxes while working.
Part B covers preventative care and additional services so it has a monthly premium. If you need prescription drug coverage, it’s best to enroll in a Part D plan or a Medicare Advantage plan (Part C). These are offered by private Medicare-
If you’re already participating in Part A and need drug coverage, enroll in a stand-
If you’re still working and become qualified for Medicare, you can drop your employer’s coverage and join Medicare if desired. But you don’t have to if the coverage you currently have is better or more affordable. If you work for a small business, and your company has fewer than 20 employees, it’s recommended you enroll in Medicare Part B. Some companies even require it. In those cases, Medicare becomes your primary coverage, and the employer plan becomes secondary. (This helps the company save money).
If your spouse is not yet eligible, it’s best to stick with your current employer coverage to ensure they are also covered. If you decide to enroll later when you retire, you’ll be given a special window of eight months to complete enrollment in a Medicare program.
When choosing the right plan, you should always speak to your doctor about the kind of healthcare services they think you’ll need in the future. You can use this information to figure out which plan offers the most value.
Medicaid is a jointly-
Medicaid has some of the same Benefits are Medicare, such as inpatient and outpatient hospital care. However, some states offer additional service coverage. In Maryland, for example, Medicaid covers prescription drugs and very limited dental coverage. For adults, dental is available for pregnant mothers and for people in the Rare and Expensive Case Management (REM) Program. Otherwise, stand-
Though states differ, all state programs offer basic healthcare service coverage, which includes nursing facility care, home healthcare, doctor services, rural health clinic care, x-
Eligibility for Medicaid is means-
Qualifying for Both
Since dual eligible individuals are often the poorest and sickest older adults, there was been a more recent effort to better integrate the two programs. For example, the Affordable Care Act established a type of D-