Medicare vs. Medicaid

Medicare and Medicaid are two separate public health care programs that are offered in the United States. Medicare is reserved for people who are above age 65, as well as people below that age who have been diagnosed with a qualifying disability. Medicaid, on the other hand, is designed for individuals with low income and few assets. Some people even qualify for both programs at the same time.

We’re here to help you learn more about Medicare and Medicaid and help you find out if you are eligible for either program.

What is Medicare?

Medicare is a public health insurance program that provides health care benefits to people who are above age 65 and people who have collected disability benefits for at least two years. People who have been diagnosed with End-Stage Renal Disease or Amyotrophic Lateral Sclerosis can qualify to receive benefits before the two-year time requirement.

Original Medicare

Original Medicare is Part A hospital insurance and Part B medical insurance. Part A covers treatment that occurs within a hospital or other medical facility, while Part B covers any medically necessary or preventive services you may need.

To get Original Medicare, you must apply and pay your Part A and B premiums. Some people qualify for premium-free Part A coverage, but this is not the case for everyone. To determine if you are eligible for premium-free Part A benefits, please reach out to Advocate Health Advisors.

Medicare Advantage

There is an alternative option available for Medicare recipients who do not want Original Medicare as their primary health insurance plan. Medicare Advantage plans are privately offered and provide a variety of useful benefits. Each plan is structured differently but includes all the same coverage as Original Medicare, and many include supplementary benefits like prescription drug coverage.

Other additional benefits in your Medicare Advantage plan include dental coverage, meal delivery, or transportation. To find out more about Medicare Advantage plans near you, speak to a Medicare professional now.

What is Medicaid?

Medicaid is America’s public health insurance program. It exists to help people with low income get vital health care coverage. The program covers around 20% of all Americans, which is more than 75 million people.

Medicaid benefits cover a broad range of health care costs, and the plans are designed to limit out-of-pocket costs for the beneficiary. In most cases, Medicaid programs are run at the state level, but they do have some federal oversight. Medicaid programs have the flexibility to determine covered populations, covered services, health care delivery models, and the way they pay health care providers.

Through Medicaid, the federal government guarantees two things to Americans. The first is that all Americans who meet Medicaid eligibility requirements are guaranteed coverage. The second is that states are all guaranteed matching federal dollars without a cap for qualified services provided to eligible enrollees.

Who Qualifies For Medicaid?

To qualify for Medicaid, your income must fall below a certain range. Financial eligibility requirements vary from state to state, so contact an insurance professional to learn if you qualify. There are also non-financial criteria that must be met, so be sure to ask about those too.

Now, suppose you qualify for both Medicare and Medicaid. In that case, you will qualify for a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP). This plan will allow you to get coverage from both Medicare and Medicaid.

Learn More About Medicare and Medicaid

If you need health insurance now, Medicaid or Medicare may be the solution for you. We can help guide you through the enrollment process, just give us a call at 720-642-1107.  Our agents will walk you through the process of applying for or enrolling in either one of these insurance plans.