Over the course of the past few years, individuals have incorrectly used the terms Medicare and Medicaid interchangeably. Of course, with so much information out there, it is understandable why it is difficult to decide on which government program works best for you or a loved one. Below, we have provided answers to some of the most common questions about these two programs.
| Medicare (In Total) | Medicaid | |
| What is the Program? | A federal program set up to cover the expenses related to medical care and treatments after reaching retirement | A program sponsored by both state and federal governments to assist households below a certain amount of the poverty line with healthcare expenses |
| What are the Eligibility Requirements? | U.S. Citizen or permanent resident age 65 or older, under 65 with a disability, or in the final stage of kidney disorders | Based on income level and family size determined by Medicaid eligibility requirements |
| What is the Cost? | Monthly premiums and deductibles or none at all depending on the mix of programs | No payments required for covered expenses – may have a copayment |
| What does it Cover? | Several parts that offer coverage for different aspects of care or coverage gaps | Vary by state, but many health and major medical events covered |
| Can you have Both? | Yes | Yes |
The different parts of Medicare/ Medicare Advantage
An area of confusion with Medicare is:
“What are the “parts” of Medicare available to me and how do I know which I want?”
The most common parts of Medicare are Parts A-D, and each state has programs available to educate individuals and their families on options and costs. A further breakdown of each part is below:
| Medicare Part A | Covers skilled nursing care, hospital services, hospice services, and home healthcare |
| Medicare Part B | Covers outpatient hospital care, physician services, and other traditional services covered by health insurance plans |
| Medicare Part C/ Medicare Advantage | In an attempt to cut costs and to bring in the private sector, Congress passed H.R.1 – Medicare Prescription Drug, Improvement, and Modernization Act of 2003 which created Medicare Advantage. These plans often contain a mix of the above parts and are part of a comprehensive one-stop-shop approach to Medicare. |
| Medicare Part D | Run by approved private insurers to pay for prescription drugs |
What does Medicaid include?
Even though each state varies on benefits, the following services are always covered through Medicaid:
Where can I get more information?
For additional information and resources, please visit the official websites for Medicare and Medicaid. You can also schedule a time to chat with our team here at My Financial Coach to see how these programs fit into your overall plan.
