According to a recent report from the Centers for Medicare and Medicaid Services (CMS), the number of insured Americans reached an all-time high. Thanks to Medicaid benefits expansion through the ACA, 35 million people now have coverage. But that number includes only low-income individuals under 65 years of age.

These facts beg the question, what about the over 65 population? What are their health insurance options? Well, the short answer is Medicare.

But now you’re probably wondering, ”What’s the difference between Medicare and Medicaid?” Keep reading to find the answers to all your questions.

Difference Between Medicare and Medicaid

Medicare and Medicaid plans are both government-sponsored health insurance programs. And they both help to cover the cost of healthcare. But who and what each plan covers make them unique.

Medicare plans are federally funded and designed for seniors and people declared handicapped. Eligibility for Medicare is not dependent on income level. But those who apply must have paid taxes for at least ten years.

Medicaid is funded at the federal and state level. Its purpose is to assist low-income families in securing health insurance, regardless of age.

Medicaid also provides coverage for children whose parents’ income exceeds the household limit. These children qualify for the Children’s Health Insurance Program (CHIPS).

Medicare Plans

The benefits of Medicare plans are much like company-sponsored plans. They cover inpatient and outpatient services, as well as prescription medicine. But to have the full range of coverage, seniors must submit several Medicare forms:

  • Medicare Part A – hospital stays, hospice service, home healthcare, and nursing care
  • Medicare Part B – outpatient hospital visits, preventative care, physician appointments, and medical devices
  • Medicare Part C aka Medicare Advantage – dental, vision, and maybe prescription drugs
  • Medicare Part D – alternate coverage for prescription drugs

Most individuals choose the Original Medicare coverage. It includes parts A and B and the government pays for your healthcare. And you can see any doctor that accepts Medicare insurance.

Medicare vs Medicaid Costs

The cost of healthcare is another difference between Medicare and Medicaid. With medicare, the insured pays premiums, deductibles, and other out-of-pocket costs. And those costs differ for Medicare parts A–D.

Click here to find more Medicare information, including the enrollment period and current rates.

For most Medicaid recipients, there are no associated medical fees for covered expenses. But very few may find themselves paying a small co-payment. And in some states, enrollees share the cost of their Medicaid insurance if they fit specific criteria, including:

  • Pregnant women, the disabled, or workers whose income exceeds 150% of the federal poverty level
  • Disabled workers eligible for certain work incentives
  • Disabled children
  • Medically needy individuals

Do You Qualify for Medicare or Medicaid?

Once you understand the difference between Medicare and Medicaid, you can plan accordingly. But knowing the right forms to complete for Medicare coverage can get tricky. Speak with an expert to find out all you can and also get a quote.

Check out our other blogs for updated news and information if you found this information useful.

By Manali