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What is the difference between Medicare & Medicaid?

Status: Open    Jan 04, 2015 - 12:12 PM


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Aug 20, 2015 - 07:49 AM

Although their names are confusingly alike, Medicaid and Medicare are quite different programs. Both programs provide health coverage, but Medicare is an “entitlement” program, meaning that everyone who reaches age 65 and is entitled to receive Social Security benefits also receives Medicare. (Medicare also covers people of any age who are permanently disabled or who have end-stage renal disease.) Medicaid, on the other hand, is a public assistance program that helps pay medical costs for individuals with limited income and assets. To be eligible for Medicaid coverage, you must meet the program’s strict income and asset guidelines. Also, unlike Medicare, which is totally federal, Medicaid is a joint state-federal program. Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive federal money, which pays for about half the state’s Medicaid costs. (The state picks up the rest of the tab.) Medicare and Medicaid Coverage of Long-Term Care The most significant difference between Medicare and Medicaid in the realm of long-term care planning, however, is that Medicaid covers nursing home care, while Medicare, for the most part, does not. Medicare Part A covers only up to 100 days of care in a “skilled nursing” facility per spell of illness. The care in the skilled nursing facility must follow a stay of at least three days in a hospital


Aug 20, 2015 - 09:11 AM

There is understandable confusion between Medicare and Medicaid programs. While both programs provide health coverage, Medicare is an “entitlement” program, eligible to everyone who reaches 65 years of age, whereas, Medicaid is a public assistance program that helps lower income and asset individuals pay for medical costs.
Medicare is a federal insurance program, primarily serving individuals over 65 years of age, regardless of their income. Medicare is not a free program. Patients pay part of the costs through deductibles for hospital bills and are required to pay monthly premiums. Medicare is split into four programs, Part A–Hospital Insurance, Part B—Medical Insurance, Part C—Medicare Advantage, and Part D—Medicare Prescription Drug Coverage. In order to have coverage under the four parts, an individual is required to pay premiums for each.
If an individual cannot afford the cost of the Medicare premiums, Medicaid is a second option. Medicaid is a state-run assistance program, based on serving low-income people of every age. Eligibility for Medicaid is based on personal income and assets. If a person has limited assets (less than $2,000) or is blind or disabled by Social Security Administration or Division of Medical Assistance, Medicaid covers a broader spectrum of services compared to Medicare. For instance, Medicaid does cover services not normally covered by Medicare, like long term support (nursing home costs) and services and personal care services. Because Medicaid is a state and local run financial assistance program, eligibility varies from state-to-state. The best way to find out if you are eligible is to contact your state’s Medicaid office at The discrepancies between states eligibility requirements regarding Medicaid is why contacting your attorney is important. Due to the important nature of selecting a Medicare or Medicaid program, it is advisable to contact your lawyer in your state for additional assistance.

Source: Answer provided by Jeffrey Puff, Esq., Puff & Cockerill LLC, Woodbury, NJ


Jan 04, 2015 - 02:14 PM

Medicare is insurance that will pay for things like doctors, hospitalizations, some medical equipment and short term rehabilitation. It is available to anyone over 65 and is not income dependent. Medicaid is based on being low income, must be applied for and can be used for skilled nursing and certain other long term care. The medicaid application process can be lengthy and confusing but there are organizations that can help with the application and questions.
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