What is the Difference Between Medicare and Medicaid?

Both Medicare and Medicaid are healthcare programs operated by the government, but you may want to know the difference between Medicare and Medicaid before you apply for assistance.

The Affordable Care Act now requires that all Americans have health insurance or pay a penalty when they file their taxes. Both Medicare and Medicaid coverage provide you with health insurance. Those the programs are fairly similar, there are some key differences between each program.

Who Qualifies for the Plans

A common difference between the two is who qualifies for and who can use each plan or program. Medicare is a type of insurance that is automatically available to those who reach the retirement age of 65. The money that you paid into the system over your career covers your healthcare needs later. Medicaid is more of a supplemental plan that is open to those who make less money. Whether you qualify for the plan depends on the number of people in your household and your household income. Medicare is also available to those with disabilities that prevent them from working a standard job.

What the Plans Cover

The biggest difference between these two programs relates to who qualifies for each one. Both plans cover many of the same services and treatments that you might need. You can visit your regular doctor for an annual check up or when you suffer symptoms and need to speak with a professional. The plans also cover the cost of emergency room visits, visits to urgent care centers and trips to a specialist. You should get coverage for your prescriptions as well, but both plans usually require that you make some type of payment on your own for those medications.

Out of Pocket Costs

Medicaid and Medicare both cover some of the costs associated with your healthcare, but these programs do not usually cover the total amount that you owe. If you qualify for Medicaid, you will receive a card that you can present when paying for medical services. You may need to make a co-pay at the time of your appointment. With Medicare, you also pay a small co-pay for some services, but you’ll also need to make regularly monthly payments to cover additional services like a stay in a hospital. If you owe more after your appointment, you’ll receive a bill directly from your healthcare provider.

Using Both

Though there is a difference between Medicare and Medicaid, you may find that you qualify for coverage from both plans. According to Marlo Sollitto, having both types of plans can help you qualify for more coverage. She claims that Medicaid may cover the co-payments and out of pocket costs associated with your Medicare plan and that you may get help paying for extended care as well. Those who qualify for both will need to meet some specific requirements. Your annual income must fall below the low income level, and you will need to either suffer from some form of disability or be 65 or older.

Medicare and Medicaid are two programs that provide health insurance to those in need. These plans cover prescriptions, hospital stays, doctors visits and much more. The biggest difference between Medicare and Medicaid is that Medicaid is open to those who have a lower income and Medicare is open to the disabled and the elderly.