Medicaid and Medicare are government programs that offer individuals who are in need of healthcare support with assistance. But the two differ in certain ways. You might be confused about the details of how each of them works but below is a better understanding of both medicare and Medicaid and their accessibility, especially if you are 65, older, or caring for someone who has a disability.
What is medicare?
Medicare is an insurance health program facilitated by the federal state to Americans who might be suffering from diseases such as end-stage renal diseases, young people with disabilities, and most commonly, individuals aged 65 or older regardless of their income. Medicare has two parts which are Hospital insurance (Part A) and Medicare insurance (Part B). A federal government agency that goes by the Centers for Medicare & Medicaid Services runs the federal program that can be accessed everywhere in the United States. The medical bills incurred are usually paid from the trust funds of those covered by the insurance program. Patients covered by the insurance health program have to pay small monthly premiums for non-hospital coverage. The patients are also required to pay some part of the medical expenses through deductible for hospitals and any other costs that may arise. With Medicare, you can access an array of healthcare services such as prescription medicines and hospital treatment for free or at a significantly lower cost.
What is Medicaid?
Medicaid is a federal program that the state governments provide in a bid to offer eligible Americans who have limited incomes with health coverage. The program is run by state and local government within federal guidelines and provides low-income people of every age with medical assistance. With Medicaid, patients won’t have to pay costs for covered medical expenses. There are, however, instances when a small copayment will be required of you. The state government determines the payment rates and eligibility of individuals who would like to access these services. The state is also responsible for setting a scope for individuals who are outside the mandatory eligibility groups that can access Medicaid services. Statistics show that the Medicaid program has been able to help one in five Americans. Medicaid has also been able to great benefit to diverse populations, thus making it the most accessible public health insurance program in the nation for people who generate below average incomes. Medicaid covers a wide array of health services and strives to put the diverse necessities of the people it serves first. Despite the low income, patients can access medical care at rates comparable to patients who are under private covers.
What are the differences between Medicare and Medicaid?
There are significant differences between Medicare and Medicaid programs such as:
- Medicaid covers patients who have a lower income level, while medicare programs don’t factor in your income to confirm your eligibility.
- The Medicaid program is provided and managed by the state and federal officials, while the federal government strictly administers Medicare.
Who can access medicare?
And even though American individuals of the age 65 and older as well as people with disabilities are eligible, it does not mean they automatically qualify to access the program. You can also check with your state’s Medicaid offices to confirm the eligibility of you or your family members. The following are a number of factors that determine eligibility for the program.
You qualify for medicare insurance if:
- You are a citizen of United States
- You have been living permanently and legally in the United States for a minimum of five years
- You have access to social security or railroad benefits
- You have been working for a long time enough to receive your social security benefits but have not collected them yet
- Either you or your spouse is an employee of the government or a retired employee who has been paying the medicare payroll taxes. You also need have not subscribed to the social security benefits.
- The Railroad Retirement board gives you access to a disability pension
- You have permanent kidney failure that requires a kidney transplant or dialysis
- You are diagnosed with Lou Gehrig’s disease
You are eligible for Medicaid cover if:
- You meet the criteria for qualification in the state you reside in
- If you belong on the Federal Poverty Level. This varies according to the size of a family.
How to apply for Medicaid
Applying for Medicaid is not that difficult of a task. You can reach out to your state Medicaid agency by writing a letter, contacting them via phone call, or physically availing yourself at their offices to express that you would like to access the coverage.
Can you enroll for both Medicaid and Medicare?
Yes. Individuals can be eligible for both Medicare and Medicaid covers. You can enroll on Medicare on sites like ClearmatchMedicare, GoMedicare and others. People who are in a place to access both covers are referred to as dually eligible by the government. The dual-eligible beneficiaries benefit highly as this helps significantly decrease the cost of health care when in need of treatment. Wondering how it works? Well, a general rule was set in place whereby Medicare will be the first to pay for health services, and then Medicaid will be able to step in and cover any differences present up to its payment limits.
Conclusion
The cost of health care can be quite expensive, especially if one has a serious illness. Accessing either of these covers will definitely help in easing the financial burden that comes with accessing health care. It is therefore essential for you to learn how you can enjoy the benefits of these covers.
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