Medicare vs. Medicaid
Medicaid and Medicare are the United States government-sponsored programs created to help cover certain health costs for Americans. The terms Medicare and Medicaid are usually used interchangeably or confused. While these two health programs sound very similar, they are actually different. Each program is controlled by its own set of policies and are designed for certain individuals. To choose the right program for your needs, it is vital to understand the differences between Medicaid and Medicare.
Cost
A significant difference between these two programs is that Medicare beneficiaries get to pay a larger part of the costs for covered medical services and procedures than Medicaid beneficiaries do. In fact, Medicaid beneficiaries pay no part of the cost for medical services it covers, but in some cases, it necessitates a little copayment.
On the other hand, Medicare beneficiaries have to pay premiums, deductibles, and other out-of-pocket costs for their coverage.
Eligibility
Under most conditions, you can qualify for Medicare when you reach 65 years of age or older and are a US citizen or permanent resident. And, in some cases, those under 65 with specific medical diseases (such as end-stage renal disease (ESRD) and Lou Gehrig’s disease) or who have a disability, are eligible for Medicare.
In contrast, Medicaid is based solely on income. Your qualification depends on your level of income and family. The ACA has extended coverage to cover the healthcare gaps for those with the lowest incomes and created a minimum income level that is the same in every state. Also, because Medicaid is managed both by the federal and state government, its eligibility varies from state to state.
Coverage
Medicare: There are several parts of Medicare that provide coverage for different phases of health care. Medicare Part A, referred to as hospital insurance, is associated with hospital services, home healthcare, and skilled nursing care. Medicare Part B provides coverage for physician services, outpatient hospital care, and other services usually covered by health insurance.
Medicare Part C is administered by private health insurance companies and includes all the benefits of Medicare Part A and Part B. Some Medicare Part C plans include extra benefits such as prescription drug, dental, and vision coverage. Medicare Part D helps cover prescription drug costs.
Medicaid: The benefits offered by Medicaid vary by the issuing state, but every program includes at least these benefits:
- Inpatient and outpatient hospital services
- X-ray and lab services
- Surgical dental services for adults
- Applicable medical treatments for children
- Family planning services, such as nurse and midwife birth control services
- Nursing facility services for adults
