Medicare and Medicaid are both government-provided health coverage programs. When you are looking for the health insurance program that is best for you, it is essential to understand your options. You probably have come across Medicare and Medicaid. But what is the difference, and who qualifies for which?
At Senior Insurance Solutions, I am your go-to licensed Medicare insurance agent. My goal is to help educate you on the best insurance plan for your needs. I am here to help you make educated and financially-responsible decisions when it comes to your health insurance. I am here to answer your questions, help you explore your options, and work with you to choose an insurance plan that makes sense for you.
If you are curious about who qualifies for Medicare and Medicaid, keep reading to discover more!
What is Medicare?
Medicare is a federal health insurance program designed for people aged 65 and older and people with certain disabilities. Original Medicare is a fee-for-service health plan, which means patients pay through deductibles and monthly premiums. There are four parts to Medicare known as Part A, Part B, Part C, and Part D.
Part A is hospital insurance while Part B is medical insurance. Part C — also known as Medicare Advantage Plan — is offered by private companies, whereas Part D applies to prescription drug coverage.
Eligibility for Medicare
To qualify for Medicare, beneficiaries have to meet certain criteria. Medicare eligibility includes:
- People aged 65 or older
- People under 65 with a qualifying disability
- People of any age with End-Stage Renal Disease (ESRD)
What is Medicaid?
Medicaid is a federal health care program. This healthcare coverage is a great way for individuals to access medical care at low costs. Some Medicaid coverage even allows patients to get medical treatment at no cost to them.
Eligibility for Medicaid
Medicaid program requirements vary from state to state. Many factors impact whether someone is eligible for coverage, including income, family size, and disability. To learn more about Colorado Medicaid, visit the Filter by State tool to discover eligibility.
Typically, to qualify for Medicaid, you must have a low income, be 65 years of age or older, have a disability, or meet another qualification. To apply for Medicaid, check with your state’s Medicaid office to see if you are eligible for benefits.
What Does Dual Eligible Mean?
Some individuals qualify for Medicare and Medicaid. That is called dual eligibility. If you have Medicare and Medicaid coverage, it is likely that a majority of your medical costs are covered.
Additionally, keep in mind that if you have Medicare and private insurance that Medicare is usually your primary insurance, but that’s not always the case.
Differences Between Medicare and Medicaid
Medicare and Medicaid are both federal government programs that provide financial assistance for medical services, but there are significant differences between the two.
Medicare is a federally-funded health insurance program available to people over 65 years of age and some with disabilities, while Medicaid is jointly funded by federal and state governments and is used to provide healthcare coverage to low-income individuals or families.
While Medicare recipients usually have an out-of-pocket cost each month based on the type of coverage they choose, Medicaid typically pays almost all of the recipient’s healthcare costs with little or no out-of-pocket expenses.
Another key difference between Medicare and Medicaid is that Medicare primarily covers hospital services, while Medicaid also provides coverage for long-term care such as nursing home stays. Ultimately, these two government programs play a major role in making sure even those with limited means get the healthcare coverage they need.
Get Medicare Coverage with Senior Insurance Solutions
Insurance is confusing. Applying for Medicaid or Medicare is complex, and it’s hard to know exactly what counts as covered services. When you are looking for the health care plan that is right for you, you may have considered Medicare and Medicaid. It’s crucial to know what both insurance options are and if you qualify.
At Senior Insurance Solutions, I am here to help you find the Medicare plan that makes the most sense for you. I take into consideration your budget and insurance requirements to make enrolling in a Medicare plan easy. Ready to explore your options? If you are Medicare-eligible, contact Senior Insurance Solutions to find the right health insurance plan for your needs!
