What Is The Difference Between Medicare and Medicaid?

The two names might appear to be similar but they are quite different in nature. Let’s take a look into the two programs and how they differentiate from one another.

Both Medicare and Medicaid were first implemented during the administration of Lyndon Johnson in the 1960s as they are state owned health programs. However that is as far the similarities between the two programs go, as both have marked differences between their infrastructures, services etc.

Getting to know Medicare

A state owned health insurance program, Medicare is what employees and employers invest in throughout the span of their working period and that trust fund pays for Medicare. Medicare mainly focuses on facilitating retired persons aged 65 or more, keeping aside the income bias. Younger patients suffering from end stage renal disease or other disabilities are also catered to here. The original Medicare covers only part of the coverage received by the enrollees however like all other private insurances, deductibles and premiums are paid for by the clients.

Policies like Medicare Advantage (Medicare Part C) and Supplement Plans can also be utilized by clients if they wish to supplement their provided coverage.

Here’s a breakdown of how Medicare is subdivided into different parts. Hospital services are covered by Medicare Part A. Outpatient services that are not covered by Part A, which include tests and physician visits, come under
Part B. Prescription drug coverage, recently introduced, comes under Part D.

Getting to know Medicaid

This program is directed towards clients of low income levels and it assists people of all ages. Co- payments may seldom be required but mostly no payments are required to be made for health care services by the clients. State, local and federal taxes together, pay for Medicaid. Using the federal guidelines, local governments and the state handle the program. That is why variations may occur from state-to-state in the following characteristics:-
• Physician services
• Inpatient hospital services
• Children vaccines
• Family planning-supplies and services
• Outpatient hospital services
• Nurse-midwife services
• Rural health clinics
• X-ray and laboratory services
• Prenatal care
• Ambulatory services and Federally Qualified Health-center (FQHC) services
• Nursing facilities for 21 years of age or older persons
• Pediatric and family nurse practitioner services
• For children under 21 years of age Early and periodic screening, diagnostic and treatment (EPSDT) is available
• Persons requiring skilled nursing services are provided home health care
States may also receive funding from Federal reserves for providing optional services but of these the following 34 are approved services of Medicaid:-
• Clinic services
• Prosthetic devices as well as prescribed drugs
• Diagnostic services
• Transportation
• Eyeglasses and optometrist services
• Intermediate care facilities for the mentally retarded (ICFs/MR)
• Rehabilitation and physical therapy services
• Persons with chronic impairments requiring community and home-based care
• Children under 21 years of age requiring nursing facility

Eligibilty for both Medicare and Medicaid

People who are qualified for both Medicaid and Medicare due to certain asset and income requirements are known to have dual eligibility. They are entitled to all services provided by Medicaid and it will also provide coverage of premiums for Part A and B.

Medicare is an investment you reap once you have retired. Enrollment provides you with plenty of options and the service is paid for by the combination of you and the government. However, Medicaid is not something you earn over the lifetime. It may be less flexible compared to Medicare but it is definitely reasonable and helpful.
Please get in touch with our representatives in case you need guidance.


Loading Facebook Comments ...

Leave a Reply