Understanding the Difference Between Medicare and Medicaid

How well have you planned for your healthcare? Do you have proper coverage in case anything unfortunate happens? Medicare and Medicaid are two government-run healthcare programs that were created to cater to older and lower-income citizens who cannot afford to buy private health insurance. While these programs were both introduced in 1965 to relieve low-income families of the burden of illness, they are different in many aspects.

Medicare

Medicare is run by the federal government. It is primarily created for elderly U.S. citizens aged 65 and above, but it is also available for people with certain disabilities. Here is how the program is designed:

PART A: HOSPITALIZATION COVERAGE – If you are 65 years of age or older and your Medicare taxes have been paid for at least 10 years, then you are eligible for free hospitalization. This also applies if you have a spouse who had Medicare coverage from government employment.

PART B: MEDICAL INSURANCE – Part B covers health insurance and it is available for those who qualify for Part A. It caters for services and equipment that are medically necessary, including wheelchairs, x-rays, lab work, outpatient surgeries, and doctor’s office visits. Flu shots, disease screenings, and other preventive services are also covered. A monthly premium is required for Part B coverage, as well as yearly deductibles for services rendered.

PART C: SUPPLEMENTAL INSURANCE – Part C covers all the services provided by parts A and B and more, for example dental and vision coverage. However, these services are offered by private companies as opposed to the federal government. Part C helps you save money by reducing the cost associated with paying for services separately. You should evaluate your needs and carefully consider the services available to determine whether Part C is a good option for you.

PART D: PRESCRIPTION DRUG COVERAGE – Part D covers the cost of prescription drugs. It includes a monthly premium, yearly deductible, and co-payments for certain prescriptions. Those who enroll for Part C usually (but not always) get coverage for Part D.

Medicaid

Medicaid is a collaboration between the state and federal government. It is designed for low-income citizens of all ages who are unable to meet their medical and long term care costs. Because of the federal and state partnership, each state has its own Medicaid program. If you have Medicaid coverage, you don’t have to pay anything for covered services. However, unlike Medicare which is open to virtually anyone who is 65 years old and above, Medicaid has very strict requirements. Since it is essentially designed to help the poor, you need to have a limited amount of liquid assets to be eligible. Once you reach 65 years of age, you can apply for Medicare but you’ll still be eligible for Medicaid. When this happens, your coverage may change depending on your income. If you are in the lower income bracket, you may continue to receive full benefits.

Despite a few differences in their structures, both Medicare and Medicaid are essential for those who cannot afford private healthcare services. If you need any legal advice on this or any other issue, you can count on the Amsberry Law Firm. Get in touch now at (210) 354-2244.

Written by Amsberry Law Firm

Amsberry Law Firm

Mr. Amsberry is board-certified in family and labor and employment law by the Texas Board of Legal Specialization. He is also active in family law, estate and elder law, and business law. He is a proven litigator who has argued before the United States 5th Circuit Court of Appeals and earned favorable outcomes in complex, precedent-setting employment and civil rights cases. He served as a reservist assistant judge advocate general in the U.S. Army and is a sought-after lecturer and speaker on a range of legal issues.