What is the Difference between Medicare and Medicaid?

Posted in Medicare

It can be easy to mix up Medicare and Medicaid. Both are government-funded and government-administered health care insurance programs. Adding to the confusion is the spelling of the names – identical except for the last three letters. They also sound a lot alike when they are pronounced.

Here we will discuss the differences between Medicare and Medicaid.

What are the parts of Medicare?

Medicare is a health insurance program funded and administered by the government. To qualify for Medicare coverage, a person must be:

  1. Age 65 or older
  2. A citizen of the United States
  3. Be a permanent legal resident with at least five years of continuous residency
  4. Under 65 and have received Social Security disability benefits for 24 consecutive months
  5. Under 65 with certain health conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (ALS)

Many people are automatically enrolled in Medicare when they become eligible. Medicare is generally broken down into parts:

Medicare Part A

This Part generally covers hospital and hospice care. Medicare Part A may be free for enrollees who have paid Medicare taxes for at least 10 years.

Medicare Part B

Part B covers services such as medical care, preventative health treatments and medical equipment. Medicare Part B comes with a monthly premium payment.

Both Medicare Part A and Part B have deductibles, coinsurance, and copayments. These features are set by the government and can change from year to year.

Medicare Part C

Medicare Part C is often referred to as Medicare Advantage. Medicare Advantage is also a health insurance plan, but it comes from a private insurance company. Medicare Advantage covers all of Part and Part B and may include additional services such as vision or dental care. The availability of Medicare Advantage plans differs depending on insurance company and where you live.

Medicare Part D

Medicare Part D refers to prescription drug coverage. Part D typically covers prescription medications that may not be covered under Original Medicare. Like Medicare Advantage, Part D is administered through private health insurers.

What is Medicaid?

Medicaid is health insurance funded by both federal and state governments. It is intended to provide health care insurance coverage for low-income individuals and families. It is intended to help recipients with health care costs.

Medicaid eligibility is determined by income. The requirements vary from state to state. Medicaid may offer coverage for dental work or hearing aids.

Medicaid may include coverage for prescription drugs. Other features such as deductibles, premium, and coinsurance are set at the state level.

Dual Eligibility

It is possible to be eligible for both Medicare and Medicaid. If you are over 65, have a low income, are disabled or have end-stage renal disease or ALS, you may be eligible for both Medicare and Medicaid. The Medicare-Medicaid Coordination Office helps to coordinate benefits between the two programs.


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