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Medicare & Medicaid

Know the Difference between Medicare and Medicaid and which is Better for You

Sifting through the information about Medicare and Medicaid is a daunting task. Not only is the topic complicated, but Medicare and Medicaid are constantly shifting and evolving with the political landscape. When trying to figure out which of the two services you need, be aware that the ultimate decision lies in your medical needs, your age, and your income level.

Older adults tend to rely more on healthcare services than other demographics. Medicare was established as a way to provide these vital services to older Americans. It’s been around since 1966 and is available to most adults who are sixty-five years or older, in addition to other special groups, such as those with amyotrophic lateral sclerosis or end-stage kidney disease.

Medicare is overseen by the Social Security Administration and is divided into four parts: Medicare part A, B,C, and D.

Part A covers hospital stays. If you have to spend some time in a rehabilitation and nursing facility after a hospitalization, or if you need assistance from medical professionals at home through a home health service, then Medicare A covers that as well for the first hundred days.

Part B covers the costs of a nursing facility and home health care beyond the first hundred days, in addition to most doctor and lab fees, outpatient visits, and medical supplies.

Part C, known as Medicare Advantage, is like an extension of Medicare part B. In exchange for a payment premium, a wider range of services are covered, including dental and vision services, as well as gyms and health clubs. Part D helps with some of the costs associated with prescription drugs. Together, the four parts of Medicare provide fairly comprehensive coverage. In order to maintain Medicare services, an individual must pay a yearly deductible, copays for hospitalizations and doctors visits, and payments for prescription drug coverage. The cost to the individual depends on their particular situation.

In general, Medicaid is available to all American adults with low income. This group is further specified by the category you belong to, which may be defined by age, among other qualifications. What makes Medicaid a tricky topic to navigate is that the rules are different from state to state.

Medicaid covers most inpatient and outpatient services, excluding preventive care, eyeglasses, diagnostics, and prescription drugs. In these cases, Medicaid will cover Medicare costs. You can learn more about what’s covered in your state at your local office for the department of human services.

Ultimately, whether you choose Medicare or Medicaid will depend on you, your healthcare needs, and what you can afford. If you’re over the age of sixty five, then Medicare may be the right plan for you. Your income level will determine whether Medicaid is right choice.

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