For those unsure or unaware, Medicare and Medicaid are both government health insurance programs. However, they are still different programs, and therefore require different eligibility requirements and different coverage. Essentially, Medicare is a government program designed to provide health insurance coverage for the elderly and disabled. On the other hand, Medicaid is a needs program, which means that it exists to cover the healthcare costs for the very low income individuals.
Medicare is a purely federal government program attached to Social Security. It is available to citizens and certain other legal residents at the age of 65, and also covers people who are disabled under the Social Security guidelines. It is a 4-part program which covers hospitalizations through Part A, outpatient and doctors visits through Part B (more about parts A and B), potentially private plans (Medicare Advantage Plans) through Part C, and prescription coverage, through Part D (more about parts C and D).
Medicaid is a joint federal and state program that covers healthcare costs for low income individuals. Additionally, it covers long-term custodial care for poor and elderly individuals. There is a Medicaid program for each state in the U.S., and the federal government funds up to 50% of the costs of each state’s Medicaid program.
Medicaid has strict eligibility requirements, of which are largely based on income. The rules vary by state, but most require Medicaid recipients to have no more than a few thousand dollars in liquid assets to qualify for the program. There are also income restrictions.
Services vary by state, but the federal government mandates coverage for hospitalization, doctor services, lab work, x-rays, nursing services, and clinic treatment. Each state has the option of including additional benefits such as prescription coverage, physical therapy, and dental services. People who qualify for Medicaid do not pay anything for the covered services.
In addition, Medicaid is the nation’s largest single source of long-term care (nursing home) funding.
If you or your family has any additional questions about Medicaid or Medicare, it is recommended that you seek experienced legal counsel to discuss your situation.