Many people believe that Medicaid and Medicare are one in the same. Although these government sponsored programs share a similar name, there are many differences to be aware of.
What is Medicaid?
Medicaid is a joint federal and state program helping low income individuals pay for medical related expenses.
Many people don’t realize that the federal government funds as much as 50 percent of each state’s Medicaid program. Due to the nature of this partnership between the federal government and each state, there are actually 50 Medicaid programs (one for each state) in existence.
Whereas Medicare is available to everyone, the same cannot be said for Medicaid. Instead, there are strict eligibility requirements in place. Eligibility rules vary from one state to the next, while federal guidelines stay the same. Of course, there is one thing that doesn’t change from state to state: this program is meant to assist the poor.
In addition to income and assets, there are other requirements in place.
Each state has the right to set its own coverage, however, the federal government requires that the following services be covered when medically necessary:
- Lab services
- Family planning
- Nursing services
- Doctor services
- Medical dental services
- Nursing facility services
- Clinic treatment
- Home healthcare
- Screening and treatment services for those under the age of 21
Some of the additional benefits included on the state level are as follows:
- Prescription drug coverage
- Medical transportation
- Physical therapy
- Optometrist services
What is Medicare?
Medicare is a federal program available to all United States citizens age 65 or older. Additionally, it is available to those with certain medical disabilities.
Unlike Medicaid, Medicare is available to all citizens age 65 or older regardless of income.
There are four parts of the Medicare program, including:
- Part A: hospitalization
- Part B: medical insurance
- Part C: privately purchased supplemental insurance
- Part D: prescription drug coverage
Part A is in place to cover hospital related costs, while Part B is optional and helps pay a portion of non-hospital expenses, such as outpatient services and doctor visits.
Part C offers the ability for participants to purchase private health insurance and receive all Medicare services from the selected provider.
Part D is optional and allows participants to pay a monthly fee for prescription drug coverage.
As you can see, despite the fact that Medicaid and Medicare share a similar name, they are not one in the same. There are many key differences, including the target group of each program.