If you’ve ever asked a question that generates a lot of non-answers, you know the frustration that comes with it. One question that’s asked often is, “What are the differences in Medicaid and Medicare?” The most common answer is that Medicare is a health insurance program handled on the federal level while Medicaid is a medical assistance program that also is supported by individual states. But there’s more to that. This week, we explore those differences in Medicaid and Medicare with the goal of setting the record straight.
Up first, we take a look at Medicare. It’s confusing because of the four “parts” that define it. Part A, Part B, Part C and Part D – each plays a role in how an applicant is covered, but getting to the heart of the matter in terms of what’s mandatory and what’s optional is usually where the frustration level kicks in.
Medicare’s primary goal is to help cover medical costs for those age 65 or older. Patients will still need to pay a deductible, but they’re usually quite inexpensive. Also, small monthly premiums may sometimes be required, but again, they’re heavily discounted.
Medicare is consistent no matter where you are in the U.S. Unlike its counterpart, Medicaid, the states don’t influence the coverage in the Medicare program. Whether you’re in Texas or Minnesota – you’ll receive the same coverage with the same deductibles and costs.
We’ll take a brief look at those four parts mentioned above, there are many variables, though so be sure your own efforts are applicable to your needs.
Part A is reserved for hospital costs, including nursing homes and hospice if necessary. Part B covers doctors’ visits and other medical care that doesn’t require hospitalization. Parts C and D are both optional. Part C is an alternative, offered by a third party, but that must at least cover as much as Medicare itself. Many like these because of the additional benefits. Part D is the prescription drug plan portion of your coverage. It can play a big role in how much you pay in prescription drugs. The best part is it usually covers preventive drugs, as well. Again, these are administered by third parties, so explore your options.
Unlike Medicare, Medicaid’s coverage isn’t limited to retirees and the elderly. Medicaid is a medical assistance program that allows for medical costs to be paid from various funding options – remember, each state has its own laws that govern its citizens. Low income families benefit from these both the Medicaid and Medicare programs and Medicare patients might also qualify for Medicaid coverage. Also, there are generally no co-pays with Medicaid, though it can vary from state to state.
Medicaid makes available healthcare options that a family might not otherwise be able to afford. It’s also used for those with disabilities, children, women who are pregnant and others at a disadvantage from a medical perspective. We can help you help you determine qualification for Medicaid, as well.
While this is in no way a complete breakdown, it should provide a bit of perspective in terms of what these programs are, and just as importantly, what they’re not. If you’d like to learn more about the differences in Medicaid and Medicare, contact our office.