What is the difference between Medicare and Medicaid?

Posted by Deborah Grossman-Mitchell, R.N., J.D., M.B.A. | Oct 27, 2020 | 0 Comments

Understanding the difference between Medicare and Medicaid can be confusing.  Both are major insurance programs providing healthcare to the American public.  Understanding the difference between the two programs can help you decide which program may be right for you.

Medicare is an earned-benefit program for those 65 or older and/or certain disabled persons.  To qualify for Medicare, workers must pay into the program during their working years.  Medicare has several parts:  Medicare Part A covers hospital expenses; Medicare Part B covers expenses such as doctor visits, home health care, medical equipment, outpatient procedures, objective testing, ambulance services, etc.; Medicare Part C, also known as Medicare Advantage, is optional and includes plans such as HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations); Medicare Part D helps pay for prescription drugs and is also optional.

You may apply for Medicare online at the following website: www.socialsecurity.gov/medicare/. Your Medicare benefits will begin automatically if you are already receiving retirement benefits and you reach the age of 65 or if you are in your 25th month of receiving disability benefits.

Medicaid programs operate under the guidance of each state.  Medicaid is an indigent based program and provides benefits to those who have not paid taxes while working.  Each state has its own eligibility rules and decides which services to cover.  The contact information to each state's Medicaid program may be found at the following link:  www.medicaid.gov/about-us/contact-us/contact-state-page.html.

About the Author

Deborah Grossman-Mitchell, R.N., J.D., M.B.A.

Attorney at Law/Social Security Disability Claimant's Representative


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