In this article, we will discuss the main differences between Medicare and Medicaid, as well as what is covered in each program. We will talk about how Medicare and Medicaid provide healthcare to different people at various stages of their lives and what is included in each. We will also cover some key points that distinguish between the two.
Main Differences Between Medicare and Medicaid
The primary difference between Medicare and Medicaid is that the former is primarily age-based, while the latter is a social welfare program for individuals of all ages with limited income. Medicare helps individuals who are 65 years and older, and in some cases, individuals under 65 with specific health issues can enroll. On the other hand, Medicaid is run in conjunction between the federal government and state governments, and it is designed for individuals whose qualifications are based on income, not age or disability. Medicaid assists eligible individuals and families in obtaining healthcare.
Differences in Dental and Vision Care
Parts A and B of the Medicare program do not cover dental care such as cleanings, fillings, tooth extractions, dentures, or any other dental supplies. Medicaid may cover some dental care for adults in certain states in addition to treatment in other states. This varies by state but can be a significant advantage when it comes to standalone dental care.
In some cases, Medicare Part A may cover dental care if it is received in a hospital. Most often, this won’t include routine dental care. Conversely, Medicaid covers dental care only for children.
Vision exams or glasses may be covered by Medicaid in most states. Medicare may include a basic vision exam as part of care in the first annual wellness visit or an annual care visit.
Helpful Resources to Understand Medicare and Medicaid Options
Understanding the details of Medicare and Medicaid can be challenging. There are many programs available, and it’s easy to feel lost in the details. The good news is that there are many places where you can get free help to find out which program you should enroll in. There are also other programs you may qualify for.
State Health Insurance Assistance Programs (SHIP)
State Health Insurance Assistance Programs (SHIP) provide free, comprehensive, and unbiased counseling to help you understand what is covered and program options that could help you save money. You can find out if there is a local SHIP office near you. You can also visit the SHIP website for updates.
Understanding Medicaid Coverage
Medicaid may provide free or low-cost healthcare for individuals and families that meet income criteria, including pregnant individuals, seniors, and individuals with disabilities. Over 84 million people were covered by Medicaid/CHIP in the United States as of 2021.
U.S. Medicaid rules specify certain mandatory benefits. Then, each state may choose to provide additional optional benefits alongside the basics. Since plans are managed by each state, the state decides the scope of optional benefits as well as eligibility rules.
How to Obtain Medicaid
Medicaid differs from Medicare because it is based on financial factors rather than age. These factors are considered when determining who qualifies for assistance:
- Income.
- Family size.
- Disability.
- Family status.
Individuals who might be eligible for Medicaid include pregnant individuals, teenagers living alone, parents of sick children, individuals with high medical costs, individuals who are blind or disabled, and low-income individuals and families.
States decide
Every state that meets the financial criteria for the program. Some states that expanded the Medicaid program have higher income levels in their eligibility criteria than states that did not expand it.
You can find out if your state expanded Medicaid and whether you qualify for it based on income or if you can get any other healthcare savings.
Examples of Core Medicaid Benefits
Here are some core services that may be included in Medicaid:
- Hospital stays and outpatient care.
- Laboratory services and X-rays.
- Doctor and nursing services.
- Medical and surgical dental services.
- Family planning services and midwife services.
- Healthcare facility services for individuals over 21 years old.
- Home health care for individuals eligible for healthcare facility services.
- Healthcare providers for children and families.
- Screening, diagnosis, and treatment services for individuals under 21 years old.
Can you have Medicare and Medicaid?
People who receive Medicare may also qualify for Medicaid to help pay for their monthly premiums and out-of-pocket costs for their program. If you can get both
Source: https://www.thebalancemoney.com/medicare-vs-medicaid-key-differences-and-coverage-4159598
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