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What Is the Difference Between Medicare and Medicaid & What Services Do They Offer

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In this article we will explain the difference between two health insurance programs that are very common for older people as well as people that do not earn much. Medicare is health insurance for people over 65 years of age or are disabled and who meet certain requirements regardless of income.

A Medicaid health insurance program is specifically for individuals and families with limited resources. There are some very important differences between these two health care services, in this article we will discuss the many differences between the two of them.

What is Medicare? Medicare is a very popular health care option for many Americans. This is a very good service for anyone that may be facing several medical situations or they meet the requirements. Medicare is health insurance for:

  • People 65 years of age or older
  • People under 65 with certain disabilities
  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)
  • Parts of Medicare

The different parts of Medicare help cover specific services, it is helpful to know all of these parts because they can be very helpful to understand in case you may need them some day. We are now going to discuss the different parts of medicare.

Medicare Part A (Hospital Insurance): This helps pay for your stay in hospitals, critical access hospitals, skilled nursing facilities, hospices, and health care at home. Most people get Medicare Part A automatically because they or a spouse paid Medicare taxes while working. If you receive Medicare Part A, you can you can still sign up and pay a premium.

Medicare Part B (Medical Insurance): This helps you pay for medical services, outpatient care, durable medical equipment and health care at home. You pay for certain preventive services. Most people will pay the standard monthly premium for Part B of Medicare. You can buy a Medigap (Medicare Supplement Insurance) from a private lender to help with the “gaps” in coverage in the Original Medicare company.

Medicare Advantage plans (Part C): Medicare Advantage Plans provide all services covered by Medicare Part A and Part B of Medicare. These plans are offered by private insurance companies approved by Medicare. Generally they include the option of Part D (prescription drug coverage). Some Medicare Advantage plans include additional benefits at an additional cost.

Medicare Coverage For Prescription Drugs (Part D) This plan helps cover prescription drug costs. You can help reduce drug costs and protect against rising drug costs. Costs and benefits vary by plan, and additional help is available. If you have limited income and resources, you may qualify for help with the costs of your medical care and / or prescription drug coverage in Medicare.

What is Medicaid? Medicaid health insurance is available for certain individuals and families with limited income and resources. The rules apply for counting your income and resources (like bank accounts or other items that can be sold in cash) depend on the state in which you live.

Eligibility For Medicaid: Eligibility may also depend on your age and if you are pregnant; if you are blind or have other disabilities; and if you are a citizen of the United States or a legal immigrant. If the pregnancy and birth of a woman is covered by Medicaid, your baby may be covered by Medicaid for up to one year without request.

Applying For Medicaid: Even if you are not sure if you qualify for medicare, if your income is limited and you or someone in your family needs medical care, you should apply for Medicaid and ask a social worker in your state to review your situation.

Nursing Home Care: People with Medicaid may also get coverage for certain services such as care in a nursing home. Depending on the rules in your state, you may have to pay a fraction of the cost (co-payment) for some medical services. If you qualify for Medicare and Medicaid, most of your health care costs are covered.

Using the SHIP Program: Do you have children or grandchildren who need health insurance? The State Health Insurance Program (SHIP) offers access to low-cost coverage for children in families who earn too much to qualify for Medicaid but not enough to buy private health insurance.

How to Qualify For SHIP: Generally, children from families with incomes up to $44,700 per year (for a family of four) may be eligible to receive free or low-cost coverage that pays for doctor visits, dental care, prescription drugs, hospital stays and more. In many states, families may have a higher income and their children may still qualify.