Medicare vs Medicaid

Diagram of medicare

Medicare vs Medicaid-many people get the two confused often. Both are run by the government and are related to health care…but what’s the difference? These are actually two very different programs that assist different people and their specific needs.

Medicare is for those age 65 and up, it’s a health insurance program run by the federal government. Those under the age of 65 with certain disabilities or who are of any age and have End Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS) can qualify as well. There are four different parts of Medicare that help cover specific services: Medicare A, Medicare B, Medicare C, and Medicare Part D.

Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health services. Starting at age 65, you normally won’t have to pay a monthly premium if you or your spouse paid Medicare taxes while working and are eligible to receive Social Security or Railroad benefits. However, there are some exceptions. Medicare B covers certain doctor services, preventive services, outpatient care and medical supplies. Medicare Advantage Plans (Part C) is a type of health plan offered by a private company who contracts with Medicare to provide all of your Medicare A and B benefits. Lastly, Medicare D, Prescription coverage, allows outpatient prescription drug coverage. You can only get this through private insurance companies that are contracted with the government (but not provided directly by them).

Medicaid is a joint federal and state program that assists people and families with lower, limited income and resources, to help pay health care costs. It is the single largest source of health care coverage in the U.S. Each state creates its own Medicaid program that follows federal guidelines, there are mandatory benefits and some optional benefits. Some of the mandatory benefits include; care and services received in a hospital or skilled nursing center, care and services received in a federally qualified health center or rural health clinic, and more. Costs for Medicaid depend on income and the state-specific rules. Some groups are exempt from most out-of-pocket costs.

Original Medicare is the way most people get their Medicare, and is Part A & B. Most people are enrolled in Parts A and B automatically when they turn 65. The cost varies depending on the coverage you choose. Some are considered “dual eligible” and qualify for both Medicare and Medicaid. If you qualify and enroll in both programs, the two often work together to cover most of your health care costs.

CompassionCare Hospice accepts both Medicare and Medicaid. We also take commercial insurance and are one of only three hospices contracted with the VA.