In 2021, over 76 million individuals were enrolled in Medicaid. Almost 64 million individuals were enrolled in Medicare. These popular programs provide life-saving medical coverage to large parts of the population.
However, many people get confused by the differences between Medicare vs Medicaid. If you’re trying to choose between the two, it’s crucial that you understand both plans. Let’s take a look at both types of coverage.
What Is Medicare?
Medicare is a program that provides health insurance to eligible people regardless of income. Most individuals who use Medicare are those over age 65. However, younger people who are disabled or on dialysis are also eligible for Medicare coverage.
Medicare beneficiaries pay deductibles and co-pays for their care. The majority of care is paid for using trust funds that are funded by taxpayers.
What Are the Available Medicare Plans?
There are multiple coverage options available for people using Medicare. Parts A and B are the original plans that are sometimes also known as hospital insurance. These plans cover part of inpatient hospitals, skilled nursing facilities, home health, or hospice care.
If you or your spouse has paid income taxes towards Medicare for at least 10 years, you don’t have to pay out-of-pocket premiums.
Medicare Part B, or medical insurance, works like traditional health insurance. This plan covers preventive services and many other medical care costs. There is a deductible and monthly premium that is only raised for higher-income individuals.
There are some medical costs that Original Medicare does not cover. This includes prescription drugs, long-term care, dental and eye care, dentures, and hearing aids. As a result, Medicare Part C (Medicare Advantage) and Medicare Part D are available as supplements through private insurers.
Medicare Advantage bundles Parts A and B together so that beneficiaries only have to deal with one insurer. These plans also usually include prescription drug coverage. You can get coverage over the phone like how TRKing selling Medicare clients work.
Medicare Part D provides prescription drug coverage. Premiums and co-pays vary but Medicare puts an upper limit on the annual deductible.
What Is Medicaid?
Medicaid is an assistance that helps low-income individuals get access to health coverage. The federal and state governments offer Medicaid together. Medicaid requirements and options vary between states.
A person must usually have an income at or below 133% of the federal poverty level. Or they could qualify from experiencing blindness or a disability or having significant health needs.
If your income is higher than the threshold, you would need to qualify based on medical needs and live in a state that offers a “medically needy program.” Individuals who cannot meet these requirements would need to pay out of pocket for medical care to spend down their income.
What Does a Medicaid Plan Cover?
Medicaid plans must offer certain benefits. This includes many hospital services and preventative care. It also covers labwork and transportation along with some other benefits.
Mandatory coverage also includes family planning, pregnancy, and pediatric care. States may also choose to offer optional benefits including eye and dental care, and prescription drug coverage. They may also offer physical and occupational therapy and hospice care.
Understand the Differences Between Medicare vs Medicaid
Medicare and Medicaid seem similar on the surface. However, they each work in different ways to provide health coverage. It’s important to understand the differences between Medicare vs Medicaid so you can make the right choice for your care.
Check out our other articles to learn more about health topics you should understand.