What’s the Difference between Medicaid and Medicare?
Jesica L. ThorsonJesica L. ThorsonMedicare is a federal health insurance program for individuals over 65 or with certain disabilities. Traditional or original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). It can also include Part D (prescription insurance).
Part A and Part B will cover medically necessary services without network restrictions; however, they may not cover routine exams, vision, dental, or hearing coverage.
Medicare Advantage plans are Medicare-approved plans offered by private insurance companies. These policies are referred to as Part C.
Because these are private plans, there are provider networks and may require prior authorization; however, they will often include vision, dental, and hearing coverage. Open enrollment for these plans is from mid-October to the beginning of December.
Medicaid is a joint federal and state health insurance program for individuals with low income, pregnant women, the elderly, and people with disabilities. It is a need-based program that is administered by each state.
Medicaid covers benefits that Medicare doesn’t, such as nursing home care, home-based services, and transportation.
If you are qualified for both Medicare and Medicaid, Medicare will pay first, and Medicaid may cover costs such as copayments and deductibles.
