Despite having similar names, our aim is to compare Medicare vs Medicaid and their unique features that can be noted through an in-depth study. These are major public health insurance options targeting different people.
For this purpose, you must know the specific purpose of each plan and the government body that administers it. Keep in mind you also need to know the eligibility criteria for both plans before making a choice
Except you are dual-eligible and can enroll for both plans, the knowledge from your study determines your overall health insurance decisions. With that in mind, this article focuses on pointing out all the necessary details you need on Medicaid and Medicare.
Comparing Medicare vs Medicaid
Medicare is an American program that provides health insurance for seniors aged 65 and older and also covers people with disabilities. Under this plan, enrollees have a rich option of medical services to help them stay healthy. Medicare enforces a risk-sharing mechanism through insurance charges and out-of-pocket costs.
On the other hand, Medicaid concerns the health coverage of people who can’t afford insurance. This covers all low-income earners and financially vulnerable individuals regardless of their age.
With these plans, there are obvious differences you can employ to tell one from the other. These differences include their management, coverage features, and eligibility factors.
How does Medicare and Medicaid work
Medicare comes in four packages that cover specific medical services. There’s Medicare Part A (hospital insurance, or inpatient care), and Medicare Part B (medical insurance, or outpatient care) tagged the original Medicare.
Then you have Medicare Advantage Part C and Part D for prescription drug coverage.
For example, Mr. Jonas finds he needs health insurance to reduce the cost of health care. If he has paid his Medicare taxes during his working years, he becomes eligible for the coverage benefits.
Under Medicare, he can choose any of the four plans depending on his needs. Say, he suddenly develops an illness that requires inpatient care, Part A then comes into play.
However, Part B may serve him for doctor’s visits while he can access his prescription drugs in Part D. He can tap into extra benefits from private insurers and other services under Part A and D by choosing a Medicare Part C plan.
More on Medicare vs Medicaid
With Medicaid, all coverage benefits come under one plan, and you have to meet the income limit in your state to qualify. If the poverty level in your state is $20000 and your annual income is $18000, you are eligible for Medicaid.
For example, Meghan, whose annual income is below the poverty level, sends proof of her earnings through her state’s health department. After verification, she gets approval to join Medicaid along with a card that gives her access to health services under the plan’s network. From preventive care to doctor’s appointments down to prescription drugs, she gets access at minimal or no cost. She can always update the office whenever there’s a change that can affect her coverage benefits.
It is important to note that Medicaid features vary by state, which means the features on your plan may depend on your location. Medicaid is your go-to for extra benefits not covered in Medicare. You can get the nursing home care and personal services at minimal costs
Benefits of Medicare vs Medicaid
Just like their services differ, there are special benefits you’ll note while comparing Medicare vs Medicaid.
Medicare benefits
- Sound coverage features: It provides extensive options for enrollees at a reduced cost. All services that are medically necessary, including your physician’s appointment, hospital care, and drugs, are features available on Medicare
- Access to professionals: Under Medicare, there’s a diverse network of doctors and hospitals users can visit. These providers are usually professionals in their field who you can trust for excellent treatment.
Medicaid benefits
- Affordable health insurance: Not everyone who desires health insurance can afford it. With Medicaid, those who don’t make enough money, retirees, or individuals with disabilities can get the best health services at no cost.
- State-specific benefits: All states in America administer Medicaid services and offer state-specific benefits. This means the features of your insurance plan can be adjusted to fit your location.
Conclusion
Ultimately, studying Medicare vs Medicaid side by side brings to light the vital features of each plan. This can help you sign up for a plan that supports your special needs.
