Medicare vs. Medicaid: Understanding the Difference
When it comes to health coverage, many people confuse Medicare and Medicaid. While both programs are backed by the government, they serve different purposes and have different eligibility requirements. Knowing the difference can help you or a loved one get the right coverage and avoid costly mistakes.
What Is Medicare?
Medicare is a federal health insurance program primarily for:
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People age 65 and older
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Certain younger individuals with disabilities
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People with End-Stage Renal Disease (ESRD) or ALS
Medicare is divided into parts:
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Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health care.
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Part B (Medical Insurance): Covers doctor visits, outpatient services, preventive care, and durable medical equipment.
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Part C (Medicare Advantage): Private plans that bundle Parts A and B, often with extra benefits and prescription drug coverage.
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Part D (Prescription Drug Coverage): Helps pay for prescription medications.
What Is Medicaid?
Medicaid is a joint federal and state program that provides health coverage for people with low income or limited resources. Eligibility and benefits vary by state, but it typically covers:
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Doctor visits and hospital services
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Preventive care and long-term care
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Prescription drugs (coverage varies by state)
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Additional services not usually covered by Medicare, such as personal care or nursing home care
Can You Have Both?
Yes—some people qualify for both Medicare and Medicaid. This is known as being “dual eligible.” These individuals often have most of their healthcare costs covered, including premiums, deductibles, and copayments.
Need Guidance on Medicare or Medicaid?
Sorting through Medicare and Medicaid rules can feel overwhelming, especially if you think you might qualify for both. That’s where I can help. As a licensed independent insurance broker, I guide people through their options, explain what’s covered, and make sure they get the benefits they deserve.
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Contact me today to learn more about Medicare, Medicaid, or both—and find the coverage that works for you.