What’s the Difference between Medicare and Medicaid?

Because of their similar names, Medicare and Medicaid are often confused with one another. However, the two programs are actually quite different. While both are government-sponsored programs designed to cover health care costs, each program applies to different groups of people and has different eligibility requirements. It is important to be aware of these differences so that you can know what benefits are available to you and your loved ones.

Medicare is a federal program available to anyone who is 65 or older, people of all ages who have kidney failure, or people who are permanently disabled and unable to work. There are four types of Medicare. Parts A and B (hospitalization and medical coverage) are paid through Social Security funds, while Parts C and D (supplemental insurance providing for additional coverage and prescription drug coverage) require out-of-pocket payments.

On the other hand, Medicaid is a state-run program geared toward assisting low-income individuals, including those who need nursing home care, people age 65 and over, children under 19, and other people who are blind or disabled. Because Medicaid is only available to certain individuals, there are strict eligibility requirements. These requirements vary from state to state and can change on an annual basis. The services available to people receiving Medicaid also vary between the states. Nursing home patients often use Medicaid to fund the costs of their care because Medicare does not pay for long-term custodial care.

Because there are complex rules and state-specific requirements for Medicaid eligibility, it is important to meet with an experienced attorney when deciding what your options are. Attorneys know what benefits are available to you and can help you determine which programs will finance the care that you need. Please don’t assume that you or your loved one is not eligible.