Medicare vs. Medicaid

Medicare and Medicaid are both great programs to support individuals. The main difference between the two is this—Medicare is centered around healthcare support, Medicaid is focused on financial support.

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What is

Medicaid provides financial support for basic healthcare needs. Both are similar government-run support programs, but significantly differ in how they function, the people they serve, and the service they provide.

Medicaid is available to low-income individuals and families under age 65. Your status as “low-income” is determined by your Modified Adjusted Gross Income (MAGI). With Medicaid, you’ll receive little to no-cost health services such as dental care, screenings, prevention, autism support, and more.

Both Medicare and Medicaid, then, provide healthcare benefits. However, they do not offer the same benefits, and the eligibility criteria are different. Also, you have to pay for regular Medicare coverage—the point of Medicaid is to significantly reduce or eliminate these costs.

What is

Medicare is a government insurance program in place to support older and disabled individuals. It provides health insurance, including hospital and general medical coverage for things like therapies and other necessary items and services.

You’re eligible for Medicare when you turn 65 or after you have received Social Security disability payments for 24 months. When you’re enrolled, you will make monthly premium payments to keep your coverage, a yearly deductible to access your benefits, and various cost-sharing fees.

Medicare and Medicaid Together

It is possible, however, for low-income seniors or disabled individuals to have both Medicare and Medicaid at the same time. If you are eligible for Medicare, your Medicaid eligibility is no longer based on your MAGI, but rather your Social Security income (SSI).

With both programs, most if not all of your healthcare costs are covered. This includes Part D Extra Help or a Medicare Advantage (Part C) Dual-eligible Special Needs Plan (D-SNP). Otherwise, it will be called a Medicare-Medicaid plan.

With both plans active, Medicare pays its share of the cost of an item or service, then Medicaid. This means you will pay little to nothing out-of-pocket as well.

Medicaid also covers some benefits that Medicare alone does not, including nursing home care and personal care services. If you are close to Medicaid eligibility but are just outside of its eligibility range, some states let you “spend down” to get into the program.

We are Here for You—Call Today

Better Insurance Management knows how important it is for you to understand the coverage you will receive from both Medicare and Medicaid. Give us a call today and we’ll make sure you have an idea of their coverage and how you can be eligible for both!