Sunday, August 19, 2012

Medicare vs. Medicaid: What’s the Difference?

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Medicare and Medicaid are two programs started in 1965.  These are federally funded programs that offer medical benefits to citizens.  While their names are almost identical, the programs are vastly different in eligibility, benefits, and cost.  This article will take the two programs and break them down into easy to understand terms.


Medicare is a federally funded program for the elderly and disabled.  You are eligible regardless of income or assets.  Certain disabilities are covered, while others are not.  Medicare has four parts, A, B, C, and D.  Medicare part A is for hospitalization coverage, Medicare part B is for outpatient coverage, Medicare part C is a supplemental insurance which is purchased by the user, and Medicare part D is for prescription drugs.  Anything that Medicare doesn’t cover may be covered by purchasing a private insurance policy known as Medigap.  The monthly fee for Medicare varies on which parts you purchase.  Medicare part A is free, as you’ve paid into it with taxes throughout your life.  If you are self-employed, however, you may have to pay for part A.  Part B pricing is on a sliding scale.  The average subscriber paid 99.90 in 2012.  However, if you have a higher income, your price will increase.  Medicare Part C is run by private companies, so your price will vary.  Medicare part D varies by region, but most will pay a $38 fee monthly, plus a yearly deductible of $320, depending on your region.  You will also have to pay co-pays for your prescriptions.  All of the premiums may be deducted from your social security check.


Medicaid is a jointly funded program by the federal and state governments.  This program offers health benefits to low income individuals and families, along with offering benefits to individuals with certain disabilities.  Each state has different eligibility requirements, as the Medicaid program is administered on the state level.  Most states, however, offer coverage to adults with children at most income levels.  In 2014, Medicaid will enroll any individual under 65 with an income of up to $15,000.  Medicaid is often used for long-term care, or other services not covered by Medicare or private insurance policies. 


Individuals with disabilities are eligible in every state.  In some states you are enrolled automatically if you receive Social Security Income (SSI).  Other states may offer enrollment based on your income.  Some states offer “Buy-ins”, which allow people with disabilities who exceed the enrollment income cap to enroll in Medicaid. Children with disabilities can qualify for Medicaid either under these disability-related rules, or based on household income.


Medicaid is designed to be affordable, so the costs are minimal, and vary by state.  If you have questions, contact your local Medicaid office by finding local contact numbers at Medicaid.gov.


Medicare and Medicaid are both wonderful systems to provide for those in need of medical assistance in our society.  Hopefully these systems will continue to serve us for generations to come.


Megan Wilson is a stay at home mom, blogger, and freelance writer.  She is also passionate about social initiatives like Homeless Shelter Software.



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