Adulting 101: 5 Important Facts About Medicare and Medicaid Services

Posted April 25, 2019 by in Health + Fitness

Roughly 35% of Americans are receiving affordable healthcare coverage through Medicare and Medicaid services. Although the names sound similar, both of these programs offer different coverage and have different eligibility requirements. If you’re looking to save money on healthcare costs, you may be eligible for one or both. Read on for our 5 important facts on Medicare and Medicaid services:

  1. Medicare and Medicaid Services Are Separate Programs
  • Medicare is a federally-funded health insurance program designed for seniors over the age of 65, and some disable Americans, regardless of income.
  • Medicaid is dually funded by federal and state governments. It is specifically designed to serve America’s low-income population.
  1. Medicare Has Four Separate Parts

One of the differences between Medicare and Medicaid services is the structure of these programs. If you qualify for Medicare coverage, it has four separate parts. Depending on your needs and qualifications, you will receive one or more of these parts.

  • Medicare Part A offers coverage on hospital visits.
  • Medicare Part B deals with medically necessary procedures as well as preventative care.
  • Medicare Part C includes all components of traditional Medicare coverage, but private insurance companies run it, and it may include additional benefits.
  • Medicare Part D is also provided by private insurance companies and is an optional plan that covers prescription drug costs.

Although Medicare Parts C and D come from private insurance companies, the federal government regulates them to protect those who are covered. Those who qualify for coverage may receive it from a combination of these four different parts.

  1. Medicaid Covers a Diverse Population

Medicare and Medicaid services differ in the populations they serve. Whereas Medicare specifically aims to cover senior citizens over the age of 65 (as well as some younger individuals with qualifying disabilities), Medicaid covers a more diverse population. You don’t need to be a certain age or have a disability to qualify; you just need to have a need for it based on a low income.

You can save money on your health coverage if your income meets the requirements. There are also a number of other rules and restrictions that may be difficult to navigate on your own, but healthcare professionals are working towards making the whole process easier.

According to USC EMHA, initiatives such as the CMS “Patients over Paperwork” initiative are designed to reduce the burdens on patients to understand the growing lists of rules and regulations. This makes the coverage easier to understand for those that need it.

  1. Many Seniors Receive Medicare Part a for Free

If you are over the age of 65 and qualified to receive Medicare, it is likely that you will get Part A for free. In fact, many are signed up automatically on their 65th birthday.

If you paid into the program for at least 10 years up to age 65, you will qualify for premium-free coverage. However, you still may be liable for deductibles and other out-of-pocket costs associated with Part A coverage.

  1. You May Be Dually Eligible for Medicare and Medicaid Services

It is possible to be eligible for both Medicare and Medicaid services to cover most of your healthcare costs. In this situation, Medicare pays first and Medicaid covers some (or all) of the leftover costs associated with your coverage.

Final Thoughts

Thanks to programs such as Medicare and Medicaid Services, healthcare coverage is affordable for a wider variety of people who couldn’t otherwise pay for it. Now that you know the difference between the two, now might be the right time to apply.

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