Medicare vs. Medicaid

When it comes to selecting health insurance, Medicare and Medicaid are two options most people have heard of. Often the two are even confused or thought to be the same plan. However, as you will see below, Medicare and Medicaid are vastly different and cater to different groups of people. In order to select which program is best for you and your family, it is important to understand what each has to offer.

What is Medicare?

Medicare is a program that was created for U.S. citizens over the age of 65 who cannot afford to cover expenses related to medical treatments and care. Designed to provide support to the senior community and their families that need financial assistance. There are options on a case by case basis for people under the age of 65 to receive Medicare benefits.

For those who are receiving Medicare benefits, you will be required to pay part of the cost for services such as hospital stays. At times, the cost will be in the form of deductibles while other coverages will require a monthly premium payment. Medicare also has a portion of the plan that pays for prescription drugs. Under Medicare Part D you will still be responsible for out-of-pocket expenses for these drugs.

One coverage that Original Medicare does not provide or pay for includes most routine delta care, eye exams, and vision care. To gain this coverage, you will need to look through private insurance agencies that offer Medicare Advantage plans. On the other hand, the program does a good job of helping with costs associated with inpatient medical expenses, outpatient care, and prescription drugs.

What is Medicaid?

Unlike Medicare, Medicaid is a program that focuses on combining the efforts of the federal government and the U.S. states to assist low-income groups with healthcare expenses. Some of the services that can be covered include routine medical care and hospitalizations. The main goal of the Medicaid program is to provide relief to those who cannot afford quality medical care due to a lack of financing. Because of this, normally benefits require little to no expenses.

Since Medicaid is largely a state-run program, the benefits it offers can vary from location to location. Connecting with a Medicaid caseworker can be beneficial as they can explain what benefits are best for your situation. Even though the program details are different depending on geographical location, the following is common in all policies:

  • Inpatient and outpatient hospital services
  • Adult nursing facility services 
  • X-ray and lab services
  • Adult surgical dental services
  • Coverage for family planning services, like midwife services and birth control
  • Children health screenings and medical treatment
States are required to include dental benefits for children but not adults. Even though there is no minimum standard, some states will still provide dome dental coverages for adults. Geographically, some states will also offer optional vision coverage.

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