The difference between Medicaid and Medicare

On Behalf of | Nov 19, 2021 | Firm News |

The government provides several health insurance programs for people in New York who are 65 and older or have a disability. Two of the most common types of health programs are Medicaid and Medicare, but they differ.

Overview of Medicare

Medicare is an insurance program that covers some of the medical costs of citizens 65 and older as well as younger people who have an eligible condition. As with traditional insurance, the insured pays a deductible to activate coverage and a monthly premium that isn’t dependent on income. Standard Medicare includes four parts:

• Part A for inpatient for hospitalization, including in-home care and skilled facilities
• Part B for outpatient services, such as preventive care, ambulance, and clinical studies
• Part C Medicare Advantage plans
• Part D for prescription drugs

Medicare Advantage is a newer plan that includes all the parts of the original Medicare with more overages, such as dental. To qualify for Medicare, a patient or their spouse must have paid taxes into it for 10 years.

Medicaid Overview

Medicaid is an assistance program available for everyone regardless of age and work history, primarily serving the needs of low-income people. To qualify, the insured must meet one or more of the following requirements:

• They are pregnant.
• They have limited income and resources but are the guardian of a qualified child.
• They are blind or disabled with limited income and resources.

Each state has varying income requirements, but they commonly must not have over a certain dollar amount in assets. To protect assets from getting counted, an applicant can participate in a Medicaid and asset protection trust.

Recipients commonly pay no premiums or very low premiums, but they often need to pay the copays. Benefits vary among states, but Medicaid generally must cover certain benefits, including X-rays, labs, and clinical visits.

It is possible that an applicant can qualify for both programs. Depending on their state and income, they may receive medical benefits to help offset the cost of care.