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Both Medicaid and Medicare are public health insurance systems. In the United States, they serve different populations and have additional eligibility requirements.
What is Medicare?
The government runs a health insurance program called Medicare. This program mostly helps Americans 65 and older, certain younger disabled people, and those who have end-stage renal illness or amyotrophic lateral sclerosis. Buying prescription drugs, diagnostic tests, hospitalizations, and physician visits are some of the services that Medicare covers.
Medicare has four parts, each of which covers different services:
1. Part A (Hospital Insurance) Inpatient, skilled nursing facility, hospice, and home health care are all covered.
2. Part B (Medical Insurance) includes doctor visits, preventive services, outpatient treatment, and medical equipment.
3. Part C (Medicare Advantage) is a replacement for original Medicare provided by private insurance providers with whom Medicare has contracts. Plans under the Medicare Advantage program may provide prescription drug coverage as well as extra benefits like dental and eye care.
4. Part D (Prescription Drug Coverage) offers prescription drug coverage, either independently or in conjunction with a Medicare Advantage plan.
A person must be 65 years of age or older, or under 65 if they have a certain condition like ESRD or ALS to qualify for Medicare. Medicare is financed through beneficiary premiums, payroll taxes, and general income.
What is Medicaid?
Medicaid is a combined federal-state program that offers health insurance to those with low incomes and few resources in the United States. Anyone who is Medicaid-eligible and satisfies their state’s requirements is qualified, regardless of age. Age, disability, and family size are additional aspects that may have an impact on eligibility besides financial constraints.
In addition to hospital stays, doctor visits, diagnostic testing, prescription medications, and long-term care, Medicaid also offers a wide range of medical services. Some states could provide extra benefits like dental and vision coverage.
Medicaid is jointly funded by the federal government and individual states. Although each state is free to operate its own Medicaid program, the federal government establishes the basic rules for eligibility, services covered, and funding. The Affordable Care Act (ACA), popularly known as Obamacare, allows states to increase Medicaid enrollment.
Individuals must meet the income and resource requirements of their state’s Medicaid program to be eligible for Medicaid. There are state-specific qualifying requirements, but in general, persons earning at least 138% of the federal poverty level (FPL) are eligible. Even if their income is somewhat more than the maximum, parents, children, and persons with disabilities may be eligible for Medicaid.
Can you have both Medicaid and Medicare?
Yes, you can have both Medicare and Medicaid. If a person fits the requirements for both programs, they are referred to as “dual eligible” or “dual eligible.”
Medicare and Medicaid both contribute to the cost of your medical expenditures if you have both. Typically, Medicaid pays the bill after Medicare.
Medicaid may cover certain Medicare premiums and out-of-pocket expenses depending on your eligibility.
