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The Difference Between Medicare and Medicaid

Posted by Brad Sarkauskas | Apr 06, 2018 | 0 Comments

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what is the difference between medicare and medicaid

Medicare and Medicaid. You've probably heard of these terms regarding some sort of health insurance or government benefit program, but what exactly are Medicaid and Medicare and how do they differ? The younger you are, the less likely you are to be informed about these two, but it is never too soon to learn about something that may ultimately become a necessity.

If you're nearing the age for retirement, however, you may have a general understanding but just need a straightforward explanation. No matter which side of the fence you stand on, the following can be highly beneficial. Join us as we unlock the mystery of the difference between Medicare and Medicaid.

What is Medicare?

Medicare is a federal health insurance program for those over 65 years of age, certain younger people with disabilities, and those with End-Stage Renal Disease (ESRD). There are, however, additional requirements one must meet to get approved for Medicare. Some of the most critical include:

  • One must be at least 65-years-old or have a severe disability
  • One must have Social Security disability benefits or Social Security retirement benefits
  • Those under 65-years-old must have had Social Security Disability Insurance (SSDI) for at least two years

Medicare is run and administered by the federal government, meaning that requirements for eligibility are uniform from state to state. An individual who meets the eligibility requirements cannot be denied as a result of their assets or income.

Medicare comes in four parts:

  • Part A (Hospital Insurance): covers inpatient care, hospice care, and care in a skilled nursing facility
  • Part B (Medical Insurance): covers outpatient care, preventative services, and medical supplies
  • Part C (Medicare Advantage Plan): includes the same coverage as Original Medicare and also some of Part D
  • Part D (Prescription Drug Coverage): adds prescription drug coverage to Original Medicare, some Medicare costs plans, some Medicare Private-Fee-for-Service plans, and Medicare medical savings account plans

What is Medicaid?

Medicaid is a federal health care assistance program for individuals who cannot afford health care independently. While the guidelines come from the federal government, each state is responsible for administering it. Unlike Medicare, Medicaid references your assets and income to determine eligibility, and qualifying individuals will fall into one of the following groups:

  • Children
  • Over the age of 65
  • Pregnant women
  • Parents of eligible children

Medicaid is especially advantageous for seniors as qualifying individuals can have a large portion of nursing home expenses paid for by Medicaid and only have to come out of pocket for a small amount.

Can I have both Medicare and Medicaid?

It is possible for an individual to qualify and have both Medicare and Medicaid as the programs can work cohesively. Here's a prime example. Medicare costs cover copays, deductibles, and premiums. An individual who has Medicaid as well can have the full costs of Medicare deductibles covered. Medicaid can also cover the Medicare premium costs for Part A and Part B for someone enrolled in both programs.

Medicare and Medicaid may seem confusing and difficult to understand at first, but it is essential that you know the basics. In the event you or a loved one needs these benefits, our team of Milwaukee elder law attorneys at Heritage Law Office of Wisconsin are here to help. We understand how crucial it can be to secure the benefits needed to cover medical expenses, which is why we will take the time to meet with you, discuss your needs, and put together a catered plan of action to help ensure eligibility. Contact us today at 414-253-8500 for a free case evaluation.

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Bradley J. Sarkauskas, Attorney-at-Law

About the Author

Brad Sarkauskas

As the founding member of the Heritage Law Office of Wisconsin, LLC, attorney Brad Sarkauskas is equipped with the tools--through his extensive background in finance--to effectively represent his clients legal economic interests. With over 20 years of experience in finance, insurance, and taxati...

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