What is the difference between Medicare and Medicaid?
There are two main differences between the two programs. Medicaid is administered by the states. Medicare is a federal program. To qualify for Medicaid, your income and assets need fall within the guidelines. You qualify for Medicare based on your age or disability.
States will generally have a name for their Medicaid program. In Connecticut our program is called HUSKY. This is an acronym for “Health Care for Uninsured Kids and Youth.”
(The program originally covered children only. We had a separate program for adults. Now both programs are called HUSKY even though the acronym no longer fits.)
This program covers all or most of the cost for covered medical services. However, there is a downside. Many doctors and other providers in the state will are not on the provider list for Medicaid.
People who are covered by Medicare are called Medicare beneficiaries.
To qualify as a Medicare beneficiary, you or your spouse will generally need to have worked in the US and paid payroll taxes for ten years or more. You will also need to be 65 or older or disabled for two years or more per Social Security’s definition. These are the basic criteria. For more information, you can visit Medicare.gov.
Medicare Part A vs Medicare Part B
Original Medicare consists of Medicare Part A and Medicare Part B. Medicare Part A covers hospital stays. It also provides limited nursing home coverage. Medicare Part B covers doctor visits.
Most Medicare beneficiaries have prepaid for Medicare Part A. They paid for this through their payroll taxes.
Medicare Part B currently has a premium of about 121 for most people. If your income is substantially higher than the average, you may pay more. If it is lower, your state may pay for your premium.
Medicare Part C and Medicare Part C
Medicare Part C can cover Hospital visits, doctors’ visits and usually prescription drugs. Medicare Part D covers prescription drugs. Both of these programs are private Medicare plans offered by some of the same companies that provide group health insurance through employers. Neither the federal government nor the states offer these programs. There is significant oversight from the centers for Medicare and Medicaid however.
We assist our clients by helping them understand and enroll in Medicare health plans, Medicare supplement plans and prescription drug plans. Call is if you have questions about the difference between Medicare and Medicaid