Categories: HEALTH & WELLNESS

Understanding Medicare and Medicaid

Navigating the health care maze in the United States requires a bit of understanding and a ton of patience. What is the difference between Medicare and Medicaid? Who qualifies? What about the disabled? Let’s see if I can clear this issue up a bit for you:

Medicare

Medicare is the federal government’s health program for the elderly and the disabled. People who are at, or over, the age of 65 qualify for Medicare coverage. In addition, those people who are permanently disabled and receive Social Security Disability Insurance (SSDI) payments also qualify for Medicare. However, disabled people do not qualify for Medicare until they have been disabled and on SSDI for a total of 24 months. Medicare has four main parts, each with their own associated costs and qualifications:

Medicare Part A

Medicare Part A is the name given to the portion of the Medicare system which covers hospital stays, skilled nursing stays, home health and hospice care. Once a person has worked in the US for a total of 10 years, then Medicare Part A is free for that person to use for the remainder of their life. For people who have worked less than 10 years, Medicare Part A is available for a monthly fee.

Medicare Part B

Medicare Part B is the name given to the portion of the Medicare system which covers things like doctor appointments, preventative medical care, laboratory services, mental health care, and durable medical equipment. Medicare part B comes with a current cost of $96.40 each month. If you elect Medicare Part B coverage then the premium is deducted from your Social Security check each month.

Medicare Part C

Medicare Part C is the name given to the portion of the Medicare system which helps to cover out-of-pocket costs associated with Medicare Part A and Medicare Part B. Medicare Part C is also commonly referred to as a “supplement plan” because it is purchased from a private insurance company and is used to help supplement the costs you are expected to pay for Medicare Part A and Medicare Part B.

Medicare Part D
Medicare Part D is the name given to the portion of the Medicare system which covers prescription drugs. Unlike Medicare Parts A and B, but similar to Medicare Part C, Medicare Part D is insurance which you pay for, and obtain from, a private insurance company. There are many options currently available for Medicare Part D coverage. The best way to select an option for Medicare Part D coverage is to compare them to each other and choose the option which covers the most for the prescription medications you take each month.

Medicaid

Medicaid is a program which is partially funded by the federal government and is managed individually by each state. Medicaid is typically available to people who are low income and have few tangible assets. In order to qualify for Medicaid, your family typically has to have income which falls under the poverty line. Additionally, your family as a whole cannot own more than one home and vehicle, both of which are exempted from the qualification rules. People on Medicaid are also restricted in the amount of income they can earn and save each month.

People who qualify for Medicare, who are also low income, can qualify for Medicaid as well. In this case, Medicaid actually pays the premiums of the Medicare Part B and Part D coverage.