Medicare vs. Medicaid: Key Similarities and Differences
Understanding the key similarities and differences between Medicaid and Medicare is essential for anyone planning their health care or helping another navigate coverage. While both are government-sponsored health insurance programs, they differ in terms of who they serve, how they’re funded, and what services they cover. Below is a breakdown of what you need to know.
Who They Serve
Medicare is primarily designed for individuals 65 years of age or older, regardless of income. Medicare also covers individuals with certain disabilities or conditions regardless of their age.
Medicaid, on the other hand, is a needs-based program designed for individuals and families with limited income and resources.
How They are Funded
Medicare is a federally funded and managed program. Its rules, eligibility requirements, and benefits are standardized across all 50 states.
Medicaid is jointly funded by both the federal government and individual states, but it is administered at the state level. This means that each state, including Kentucky, sets its own eligibility rules and covered services within broad federal guidelines.
What They Cover
Medicare is divided into 4 parts. Part A covers hospital and inpatient care. Part B covers outpatient services and doctor visits. Part C is an alternative offered through private insurers. Part D provides prescription drug coverage.
Medicaid, by comparison, includes long-term care in a nursing home, custodial care, and other supportive services not typically covered by Medicare.
How They Work Together
Some individuals qualify for both Medicaid and Medicare. These dual eligible individuals can receive comprehensive coverage with Medicaid helping to pay with Medicare premiums, deductibles, and other out-of-pocket expenses.
Conclusion
While Medicaid and Medicare both provide essential health coverage, they are fundamentally different in who they serve, how they are funded, and the types of care they cover. Applying for Medicaid can be an overwhelming process. At Bluegrass Elderlaw, we help our clients by applying for Medicaid on their behalf and aiding married couples in transferring resources in order for the community spouse to not become impoverished while their spouse is in a nursing facility. Contact us for help with your Medicaid Application or Resource Assessment needs.
Disclaimer: This post is for general informational purposes only. To learn more about Medicaid, visit our website or call us today at (859) 281-0048.