What is the Difference between Medicaid and Medicare?

Insurance Coverage, Older Adults / Sanitas Medical Center

What is the Difference between Medicaid and Medicare?

The United States has been referenced as one the most important countries in the world. It has guided other countries towards global inclusion in terms of progress, human rights and justice.

To aid American people, the government created two separate social security programs to help vulnerable American citizens with their healthcare needs. You might be familiar with one of their names, if not both: Medicaid and Medicare. Today we will briefly talk about what they mean and point out some of the differences between them.

Let’s start with the basics.

These two programs were created by the federal government to assist people with the cost of healthcare. Both are funded by taxes and work all along American grounds. Both are designed primarily for citizens of the United States or very long term residents who have contributed to the country’s growth. However, although their names are very similar, they have two completely different purposes.

What is Medicaid and how can I get enrolled in it?

Medicaid is an assistance program designed to help people with low incomes. It does not have an age restriction and its copays or deductibles, if they exist, are usually very low. Eligibility for Medicaid varies from state to state, and depends on specific requirements.

Because it is designed for poor people, federal and state regulations have to ensure that those enrolled really require assistance. That is why not everyone is eligible for Medicaid. If you wish to know if you qualify for Medicaid, check if you fulfil the requirements in the Medicaid Eligibility website.

Medicaid has special consideration for children. Those who earn too much to be eligible but need low cost care for children can apply to Medicaid’s Children’s Health Insurance Program (CHIP).

So, if I am not eligible for Medicaid, can I get Medicare healthcare?

Medicare is an insurance program covered by the government. It is aimed at American citizens over 65 regardless of their income. It also covers disabled people and patients that require dialysis.

Unlike Medicaid, it is exclusively a federal program which works the same way in all America. Patients have to pay part of their healthcare costs though deductibles.

Medicare has four parts that cover different needs. Medicare Part A helps cover hospital inpatient care. Medicare Part B helps with outpatient care such as home care, annual visits, preventive visits and medical equipment. Part D is a premium service that provides certain prescription drug coverage.

Finally, Medicare Part C (also referred as Medicare Advantage Plans) is a service offered by private companies. By paying a monthly premium it gives access to Medicare Parts A & B (and even part D) plus some extra benefits regarding co-pays and deductibles that vary depending on the plan.

If you wish to know if you are eligible for Medicare, visit the Medicare eligibility tool.

I’ve heard there is something called “dual eligibility”. Is that true?

Some people can qualify for both Medicare and Medicare, if they meet the requirements, and therefore can be accepted in both programs. This is what is called “dual eligibility”. People with dual eligibility have almost everything of their health care covered by Medicare and Medicaid programs.

At Sanitas, we offer healthcare whether you are a patient of Medicaid or Medicare. Also we offer care if you are covered by commercial insurance. We are committed to your health and wellbeing. Whenever you want savings, benefits and care that go beyond, Sanitas delivers. Come to Sanitas to enjoy all we have to offer to you! Call now 1-966-358-2743 or visit www.mysanitas.com for advice and support!