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Medicare vs. Medicaid

senior couple with insurance agent While their names may sound alike, Medicare and Medicaid are two different programs. Both are government programs that can help you pay for healthcare and medical expenses, but that’s about all they have in common. Medicare is a federal insurance program for people who are 65 years or older, and for some people with disabilities. Medicaid, on the other hand, is a joint federal and state program that helps people with limited resources pay for their healthcare.

What do these programs cover?

Original Medicare comes in two parts: Medicare Part A and Medicare Part B.
  • Medicare Part A covers hospital and skilled nursing facility stays, hospice care, and some home health care costs. Most people get Part A for free (no premium) as long as they have worked at least 10 years and paid Medicare taxes.
  • Medicare Part B helps to cover doctors’ appointments as well as services, preventative and specialty services, outpatient care, home health care, and some medical equipment.
Private carriers also offer Medicare Part C plans, also known as Medicare Advantage Plans, which offer all the benefits covered under Original Medicare (parts A & B) and more, such as selecting from HMOs, PPOs and Medicare Medical Savings Account (MSA) Plans. You have the option to purchase a standalone Medicare Part D, also known as a Prescription Drug Plan, or include one in your Part C Medicare Advantage Plan.
Talk to a licensed representative before selecting a Medicare Advantage Plan to make sure you get the right coverage for you. Our licensed agents help you compare the cost of plans, review current benefits and get help with enrollment all across the U.S.

On the other hand, Medicaid provides health coverage for some low-income adults, children, pregnant women, elderly adults and people with disabilities. The benefits vary from state to state, but can include:
  • Prescription drug coverage
  • Case management
  • Physical therapy
  • Occupational therapy
  • Prosthetics
  • Personal Care
  • Hospice
  • Speech, hearing and language disorder services
  • Dental and vision services
Mandatory Medicaid benefits include:
  • Inpatient and outpatient hospital services
  • Physician Services
  • Laboratory and X-Ray Services
  • Nursing Home Facilities
  • Home health services
  • Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT)
  • Family Planning Services
  • Free Standing Birth Center Services
  • Transportation medical care
Check your state Medicaid profile here for more information on eligibility, enrolling and quality of care.

Is is possible to qualify for both Medicare and Medicaid?

Yes, it’s possible to be eligible for both Medicare and Medicaid, (known as “dual eligibility”) and they will work together to provide coverage at a very low cost. The program is funded jointly by states and the federal government.
If you think you may qualify for Medicaid in addition to your Medicare coverage, or have questions about your potential coverage in general, contact an agent specializing in Medicare today.

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