Medicaid vs. Medicare…What’s the Difference?

Many people are confused when it comes to the difference between Medicaid and Medicare. Who can blame them? Both programs start with the letter “M” and are both health insurance programs run by the government. Even though the information is available, when it comes to public benefits, the bureaucracy and procedures can be intimidating. Routinely, people ask, “What is covered?” and “Which agency covers what?”

So let’s start with Medicare. Medicare is a government benefit for US citizens ages 65 and up. If an individual younger than 65 is determined by the Social Security Administration Disability Determination Services (SSA DDS) to be disabled, they too are eligible for Medicare.

As long as you work, you make payments to Medicare. 2.9% if you are self employed, 1.45% if you are employed, and the remaining 1.45% is paid by your employer. If you are employed, then the 1.45% is deducted from your check before it is issued to you and the deduction may look like this.

The Centers for Medicare & Medicaid Services is the agency in charge of both Medicare and Medicaid, but you sign up for Medicare Part A (Hospital) and Medicare Part B (Medical) through SSA. If you’re already receiving Social Security retirement benefits, when you reach age 65 or are in the 25th month of receiving disability checks, SSA automatically will enroll you. Medicare Part C (Medicare Advantage) and Medicare Part D (Prescription Drug) plans are available for purchase in the insurance marketplace. Also, SSA administers a program called Extra Help to help people with low income/resources pay for premiums, co-pays, and co-insurance costs for Part D plans. For more details on what Medicare Parts A- D cover please visit our Medicare page.

Each state runs its own Medicaid program under guidance from the Centers for Medicare & Medicaid Services. It does not require paying taxes while working, but it does have income and resource requirements to qualify. Medicaid provides coverage for older people, people with disabilities (as determined by SSA DDS), and some families with children. Each state outlines its eligibility rules and covered services. The names of the Medicaid program may vary from state to state. Visit our Medicaid Resources page for more information.

Medicare and Medicaid are two of the major insurance programs that provide healthcare to the American public. Understanding each program, as well as how the two programs differ, can help you and those you care about find the right healthcare program.

Keep in mind that AyudaCon.com is available for investigation and assistance with your eligibility, application, and/or maintenance of Medicaid and Medicare benefits. Contact us for more information.