Medicare | Law Offices of Dr. Bill LaTour

The Difference Between Medicare and Medicaid Explained

Obtaining health insurance in this country can be difficult depending on where you are and what your income level is. There are, however, two key government health insurance programs made to help ease the burden of many Americans in need of medical attention, and the Law Offices of Dr. Bill LaTour, a South California SSDI and SSI claims firm, would like to walk you through both of them. These programs, Medicare and Medicaid, may be able to help you receive the medical care you need and deserve; though based on eligibility, one might be a better fit for you than the other.

What Are the Basic Differences, and Who Runs Them?

While both Medicare and Medicaid are federal programs, they are administered differently. Medicare is handled entirely through the federal government, and is officially to be applied only to citizens who have paid into the system and are now eligible to receive benefits. In other words, Medicare is specifically meant to cover the high medical bills of senior citizens over the age of 65, though benefits can start at 62 or even earlier depending on if a serious disability is covered by Social Security.

Medicaid does not depend on age, however, and can cover any low-income citizens who cannot afford adequate healthcare. Medicaid is also administered through each individual state, though the federal government still maintains oversight.

What Do They Cover?

What exactly Medicare covers depends mostly on the type of Medicare plan you have, though generally speaking, Medicare Part A and Part B will be what you’re looking at. To put the differences simply, Part A will cover your hospital costs while Part B is meant more for your doctor’s fees and lab costs. Other options such as Part C and Part D move in the direction of private insurance options and prescription drug coverage, though you should contact your local health services offices for more information.

Medicaid, on the other hand, is a much broader health insurance program that can cover many of the basic healthcare costs for low-income citizens. This includes not just hospital visits and trips to the doctor’s office, but also the cost of medication and even a new pair of glasses.

How Much Do They Cost?

This is where things get a little trickier. With your different Medicare options, there are yearly deductibles that vary depending on the specific plan you select. For example, Part A requires copayments for lengthy hospital stays, while Part B requires 20 to 35 percent of your medical bills plus a monthly premium. Beneficiaries may also need to pay a monthly premium and percentage of medication costs once the deductible is met.

Medicaid is a little simpler to understand, sometimes charging its user small fees for specific services. Medicaid can even pay for some of your Medicare deductibles and premiums, so if you qualify, you may want to look into enrolling in both.

Learn More about Medicare and Medicaid

Selecting the federal health insurance program that works best for you can sometimes be a tricky and at times outright difficult process, and it helps to have someone on your side who can help you out.

Although we specialize in SSDI and SSI claims, Dr. Bill LaTour is a licensed clinical psychologist, and you should reach out to one of our representatives if you have questions about how your Medicare and Medicaid relate to your Social Security benefits.

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