Difference Between Medicare And Medicaid

Medicare vs Medicaid

If you often get confused between Medicare and Medicaid, then this blog will surely help you to understand both the terms easily. Keep reading!!

Medicare and Medicaid are two different national health insurance programs sponsored by the government of the United States. Both programs are particularly designed to cover healthcare expenses for an American citizen. Established in the year 1965 and funded by taxpayers, both Medicare and Medicaid sound somewhat similar and this normally triggers confusion. Most people don’t know how both programs work and what is the coverage provided by them.

Let’s dig deeper and know more about Medicare and Medicaid!!

Difference Between Medicare And Medicaid-

Medicare 

The Medicare program provides healthcare coverage to every U.S. citizen. A person who is 65 years of age or older and people with certain disabilities are eligible to acquire this medical program. It is a four-part program that consists of the following:

  • Part A: Hospitalization Coverage-

Medicare Part A offers hospitalization coverage to a person who is 65 years or older, regardless of the total income. 

In order to qualify for this program, a person or his or her spouse should have worked and paid Medicare taxes for a minimum of 10 years. 

The majority of the people do not pay a premium for Part A, however, deductibles, as well as coinsurance, applied.

  • Part B: Medical Insurance-

People who qualify for Medicare Part A also become eligible for Part B. Part B includes medically essential services as well as equipment including doctor’s office visits, lab work, x-rays, wheelchairs, walkers, and outpatient surgeries. 

In addition to this, various preventive services including disease screenings and flu shots are also offered.

For the year 2020, the standard premium of Part B is $144.60, which is usually deducted from Social Security or Railroad Retirement payments. Both Deductibles, as well as coinsurance, are also applied. People who earn over $87,000 in a year and couples who earn $174,000 are made to pay more in this program.

No individual is mandated to sign up for a Part B plan if he or she is covered by his or her employer’s insurance. But then it can cost more to join this plan later in life as it may include a late-enrollment penalty afterward.

  • Part C: Supplement Insurance-

A person who is eligible for both Medicare Part A and Part B is likely to be eligible for Part C as well, which is known as Medicare Advantage. These plans are generally provided by private companies, which are approved by Medicare.

Part C provides coverage provided under both Parts A and B. A person can avail vision, hearing, and dental coverage with Plan C. In simpler words, it works somewhat like the health maintenance organizations (HMOs) and preferred provider organizations (PPOs) that help working people to acquire medical services during their service period.

Enrolling in Part C cuts down the total expenses of buying services. One should wisely analyze his or her medical requirements before choosing this plan. 

  • Part D: Prescription Drug Coverage-

Medicare Part D offers people with prescription drug coverage. An individual pays for this plan out-of-pocket as well as he or she should pay premiums on a monthly basis, deductibles on a yearly basis, and copayments for various prescriptions.

People who are enrolled in Medicare Part C are ultimately eligible for this plan as well.

Also Check: 5 Reasons Why Medicare Is Necessary

Medicaid

Medicaid healthcare program is a joint federal & state program. It allows low-income American citizens of every age to pay for the expenses related to medical as well as long-term custodial care. 

Children who require low-cost care but their families earn a decent income to be eligible for Medicaid, are covered through the Children’s Health Insurance Program (CHIP). CHIP has its own set of rules & requirements.

The advantages of Medicaid differ from state to state. However, the Federal government mandates it for numerous services, such as:

  • Hospitalization
  • Laboratory services
  • X-rays
  • Doctor services
  • Family planning
  • Nursing services
  • Nursing facility services
  • Home healthcare for people eligible for nursing facility services
  • Clinic treatment
  • Pediatric & family nurse practitioner services
  • Midwife services

In addition to this, every state also has an option to include various extra benefits, including: 

  • prescription drug coverage 
  • optometrist services 
  • Eyeglasses 
  • medical transportation 
  • physical therapy 
  • prosthetic devices 
  • dental services 

Often, Medicaid is also utilized to fund long-term care that is not covered by Medicare as well as by most of the private health insurance policies. 

Medicaid is believed to be the biggest single source of long-term care funding in America. It also covers the expenses associated with nursing facilities for people who spend their whole savings to meet healthcare costs and are left with no other option to pay for nursing care.

So, that was all about Medicare and Medicaid. We hope this blog helped you to get a clear picture of the difference between both healthcare programs.