What’s the Difference Between Medicare and Medicaid?

Medicare and Medicaid are both aid programs, funded in large part by the federal government to help citizens. Established in 1965 by President Lyndon B. Johnson, Medicare and Medicaid was in response to the financial burdens health care costs can be.

With such similar names, it’s easy to see why so many Americans confuse the two. The key lies in the names themselves as we’ll explain below.

What is Medicare?

Medicare is a government-run program that provides health insurance to elderly Americans over the age of 65. It also helps those with disabilities. Medicare is available to all no matter the individual’s income status.

“Care” is the key here. Medicare provides care to recipients.

What are the different types of Medicare?

  1. Medicare Part A (Hospital Insurance)
    Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  2. Medicare Part B (Medical Insurance)
    Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  3. Medicare Part D (prescription drug coverage)
    Part D adds prescription drug coverage to original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans

There is a Medicare Part C, also known as Medicare Advantage, which is an “all in one” alternative to original Medicare. Medicare Part C includes Part A, Part B, and usually Part D.

Who is eligible for Medicare?

  • Any US citizen over the age of 65
  • Any US citizen under age 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time
  • Any US citizen under 65 and with End-Stage Renal Disease (ESRD).

Who pays for Medicare?

In short, all working Americans. Medicare is funded by the social security taxes you pay on your income as well as the specific Medicare taxes you pay, premiums people pay with Medicare, and the Federal government.

What are my options for Medicare?

What’s the difference between Original Medicare and Medicare Advantage Plan?

  • With Original Medicare, the federal government pays
  • With Medicare Advantage Plan (sometimes called “Part C” or “MA plans”), Medicare-approved, private companies pay. These companies are then reimbursed by Medicare themselves.

In a Medicare Advantage Plan, all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) is covered.

What is Medicaid?

Medicaid is a state and federal-run aid program to provide health insurance as well. However, Medicaid is only available for those with low-income. Age is not a factor. Anyone in need is eligible. Medicaid is the single largest source of health coverage in the United States.

“Aid” is the key here. Medicaid provides aid to recipients.

Who is eligible for Medicaid?

  • Eligible, low-income adults
  • Children
  • Pregnant women
  • Elderly adults
  • People with disabilities

How is Medicaid funded?

Medicaid, unlike Medicare, is administered by the states but under Federal guidelines. Both the states and the Federal government split the costs of Medicaid.

Can I qualify for both Medicare and Medicaid?

Yes, some people are eligible for both Medicaid and Medicare and are known as Medicare dual eligible or “medi-medi”s.

Medicare and Medicaid are both heavily regulated, and thus, can be hard to navigate. We here at MedicareGov Directory are here to help. Contact us today to learn more about the Medicare Advantage plans we offer, to get your questions answered, and to determine the best solution for you.