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The Differences Between Medicare and Medicaid

Health care insurance these days can be confusing with all the actual changes and proposed changes being discussed. Where does one start to get a good picture of the differences between Medicaid and Medicare?

The “most” important thing to know about Medicare and Medicaid is that that two programs, despite being close in name, are decidedly different and offer their various services to different types of individuals at different ages.

Medicare is

  • A federal health care program developed in the mid-1960s, part of the Social Security program
  • Social security took money from paychecks during working years, returned it as income after 65
  • Helps offer affordable health care for seniors and reduce health care costs
  • Part A covering nursing home care, hospice, and other inpatient and hospital stays
  • Part B covering out patient medical costs (medical supplies, doctor visits, etc.)
  • Part B means paying an out-of-pocket monthly fee
  • No plan B? Sign up later, but pay a 10 percent increase for every 12 months you do not have it
  • Part C offering a health plan from a private company (PPO, HMO) called Medicare Advantage. It covers Part A, B and sometimes prescriptions. This plan can be less expensive than paying premiums for other plans.
  • Part D covering drug costs and added to whatever other plans you choose
  • Medicare is funded by a tax added to a worker’s paycheck plus premiums paid by Medicare beneficiaries plus government funding
 

Medicaid is

  • Funded by the federal government, but the money passes down to each state to allocate as they see fit
  • Medicaid was “born” about the same time as Medicare and was intended to help lower income citizens afford health care
  • Set up so that the federal government matches state funding
  • Overseen by the Centers for Medicare & Medicaid Services in each state to pass out funding and endure the state meets the federal government’s minimum standards
  • Who it funds as opposed to Medicare. Medicaid serves those with limited resources and income and that includes seniors, low-income individuals, those at the poverty level by offering personal care services/nursing home care. Recipients do not have to be 65 years or older. Those served by Medicaid are a wide ranging swath of Americans needing and qualifying for such services
  • The ability of older Americans who subsist on just Social Security to also receive Medicare benefits and classified as low income while over the age of 65
 

Of course, Medicaid and Medicare are much more than just a summary of highlights on a page. It is best to research what you want and need, what suits your lifestyle and budget and to ask as many questions as you can to understand what you are likely going to purchase. There are highly trained health insurance brokers and health insurance agents that have answers right at their fingertips and can help you make informed choices. Just do not wait until the last minute to make a decision, as often the last minute purchases are those that are regretted.

Posted on Thursday, October 31st, 2019. Filed under Medicare.

Is it possible to have Medicare and Medicaid?

You may find yourself wondering if you qualify for both the Medicare and Medicaid programs. If you are a senior with medical needs and are living on a small income, you may qualify.

Qualifying for both Medicare and Medicaid is called dual eligibility. Those that are eligible for both programs are usually low-income adults over the age of 65, or a low-income individual with a disability. This dual eligibility can be quite confusing and for that reason, the Centers for Medicare & Medicaid Services (CMS) try to ensure that each program works with the other efficiently and effectively.

CMS offers an extensive collection of resources for those searching for information on how to co-ordinate their benefits. You can find that collection here.

If you still have more questions about your eligibility contact an insurance agent. They are trained in helping individuals like you.

Posted on Wednesday, November 21st, 2018. Filed under Medicare.

What is Medicaid?

Medicaid is not to be confused with Medicare, although the two often get mixed up. Medicaid is funded by federal and state governments, helps low-income individuals and families and is really an assistance program. Also, it is for all individuals of all ages.

Each state has different qualifications for Medicaid eligibility, but one thing is constant, income levels do determine eligibility. For seniors to be eligible for Medicaid, they must pass an income, medical necessity and asset test. Should they qualify, they find that Medicaid may actually offer some benefits that Medicare does not, such as routine hearing, dental and vision care, and prescription drug coverage. There are no extra supplement plans needed if you quality for Medicaid.

If at any time you are not certain which program is for you ask a qualified insurance agent, check with the Medicaid and Medicare government websites if you are computer savvy and ask your friends. The more information you have, the better informed your health insurance choices.

Posted on Friday, November 16th, 2018. Filed under Health Insurance.

Many confuse the two government health care plans – Medicare and Medicaid

Right now it is more important than ever to understand the differences between Medicare and Medicaid. Under the new administration, things are changing so rapidly, it is hard to keep track. It may be necessary for you speak to an insurance agent to understand what are the changes may affect you.

Medicare is a federal program for all seniors 65 years of age or over. Medicaid is jointly funded at federal and state levels and is usually intended to serve lower income individuals and families.

To find out what program is right for you, you will need to speak to a highly trained health insurance agent who knows the industry, as well as their products. An insurance agent can help you choose what best suits your needs. While it is confusing, with the help of a qualified insurance agent, the choices are much easier to understand.

Posted on Tuesday, November 13th, 2018. Filed under Medicare.

The repeal and replacement of the ACA: Where is it at?

On May 4, Congress approved legislation to repeal and replace major parts of the Affordable Care Act (ACA). The latest version of the American Health Care Act (AHCA) rolls back the expansion of Medicaid and allows states to opt out of covering patients with pre-existing conditions. The bill now faces uncertainty in the Senate.

The proposed AHCA would end Medicaid’s status as an open-ended entitlement. The bill will also repeal taxes on the super rich, insurers and drug companies. Furthermore, under the new bill, states could adjust coverage for essential medical services such as maternity and emergency care. The latest AHCA seems to be a patchwork of provisions.

The bill will most likely be amended by the various Republican factions within the Senate. In addition, the Senate Republicans have been working on their own version of the health care bill, which will consider the ideas already in the House bill. Once the Senate passes its new or updated version of the AHCA, that bill will return to the House for another vote.

However, the biggest unanswered question with any replacement of the ACA is that no one can calculate how many people would be covered under a new health care bill. By May 22 the Congressional Budget Office (CBO) will release its report on the cost and potential coverage of the new AHCA. The analysis of this bill will be complicated by the fact that it leaves a lot to the states. It will be up to the Senate Republicans to consider the implications of the upcoming CBO report.

Posted on Thursday, May 18th, 2017. Filed under Health Insurance.
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