Did you know that there are 42 million people enrolled in Medicare? Medicaid enrollment numbers are even higher, partly because this program covers more than senior citizens and partly because of the new healthcare laws. As of April 2014, there were more than 61 million enrollees – and counting.
By the Numbers: Medicaid and Medicare
Between June 2011 and June 2012, more than 1.3 million people enrolled in Medicaid for the first time. In April 2014 alone – just that one month – there were an additional 1.1 million people enrolled in Medicaid for the first time. Those numbers will continue to rise as the new healthcare laws fall into place. Each of these programs serve very important roles, but understanding the differences between the two can be challenging.
Medicaid
Medicaid covers a wide range of medical needs. Those in low income homes, pregnant mothers and some seniors benefit from this medical assistance program. There are typically no copays that a patient must cover, making it ideal for those who have overwhelming medical costs and no way to pay for them.
In those states that opted to expand Medicaid funding as part of the Affordable Care Act, residents can qualify for this coverage if they do not earn enough to pay for traditional insurance policies. This is one reason why the enrollment numbers are exploding. If, however, a state opts not to expand coverage, those who wouldn’t have qualified previously still won’t be able to secure Medicaid. About half of the states have chosen to not expand their Medicaid programs.
Medicare
Medicare was signed into law in 1965 for the purpose of providing healthcare insurance for senior citizens. The program has evolved over the years and for millions, Medicare helps bridge the gap for those on fixed incomes. A few of the services Medicare covers include hospital stays, visits to the doctor and prescription drug costs, depending on what type of coverage a recipient has.
Patients will sometimes be required to pay a deductible, but for most, it’s not a problem.
Medicare also has four parts that have specific purposes for enrollees. For some, it can be confusing to differentiate between mandatory and optional services.
Because Medicare is a federal program, the benefits are consistent, regardless of which state one is in. By comparison, each state has its own parameters for Medicaid. While some of the funding is from federal sources, because the states finance their respective programs, the federal laws aren’t as specific as Medicare.
Part A – Think of this as the Medicare foundation. It covers hospital stays, any lab work you have done, surgeries and visits to your physician. It can also help cover the costs if you need a wheelchair or other supplies.
Part B – It may sound as though Parts A and B overlap each other in coverage, but there are important distinctions. Part B will cover preventive services, which includes things like flu shots. It also covers services and even supplies required to diagnose and possibly treat any medical problems you have.
Part C – This Medicare part includes plans that outside parties may offer. This mirrors HMO/PPOs that many have as part of their employment.
Part D – This is your prescription plan. It can play a significant role in how much you pay in prescription drugs.
If you need guidance through either or both of these programs, we invite you to give us a call. Our staff of experienced and compassionate estate planning lawyers stand ready to ease the stressful burden from your shoulders.
Daniel DeBruyckere
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