Svete & McGee Attorneys at Law

WHAT ARE THE DIFFERENCES BETWEEN MEDICARE AND MEDICAID

Sometimes it’s easy enough to confuse Medicare and Medicaid, both of which are government programs.  Generally speaking, Medicaid is for people with lower incomes, whereas Medicare is for older folks.

Who is Eligible for Medicare?

             Medicare is for retired individuals who have attained the age of 65 that provides health insurance sponsored by the federal government.  The nice part about Medicare is that coverage is afforded to Medicare insured individuals regardless of their medical condition.

What about Medicaid?

             The federal government provides a health insurance program which is administered by state governments.  This insurance serves people that are generally in the lower income brackets and those that are either elderly, disabled, blind or parents of minor children.

What is the Eligibility Requirements for Medicare?

Anyone reaching the age of 65 is eligible for Medicare coverage.  Also, Medicare is available to disabled individuals.

What are the Eligibility Requirements for Medicaid?

             Medicaid eligibility standards are set by individual states subject to Federal guidelines.  Families with low income, qualified pregnant women, children and individuals receiving supplemental social security are persons who must be covered under this insurance.  In order to qualify, an individual has to be financially needy, which is generally determined by income and asset tests.

What will Medicare Cover?

             Medicare has two parts:  Part A, which is for hospital coverage; and, Part B, which covers medical care such as one’s doctor, lab tests and physical therapy.  Medicare insured may elect to have Medicare Advantage which enables the insured to receive health care through managed care plans, such as Health Maintenance Organization (HMOs), Preferred Provider Organization (PPOs) and Medicare Part D coverage for prescription drugs.

Why Can’t a Retiree at Age 62 Apply for Medicare?

A retired person that opts to receive Social Security at age 62 will not be eligible for Medicare until that person reaches 65 years of age.  That is why it is very important before one decides when to enroll for Social Security that they take into consideration the Medicare coverage issue.

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