Elder Law Group Blog

What Is the Difference Between Medicaid and Medicare?

Jul 10, 2018 | FAQs

what is the difference between medicaid and medicareMedicaid and Medicare are often confused for one another. While it is true that these are both government-funded programs, how they work and who they benefit is very different.

So what is the difference between Medicaid and Medicare?

In short, Medicare provides long-term health coverage for the elderly. Meanwhile, Medicaid helps to cover the healthcare costs of individuals who cannot pay for it themselves.

What Is Medicare?

Similar to Social Security benefits, taxpayer contributions fund Medicare benefits. The majority of people who benefit from Medicare are those 65 and older. Occasionally, some disabled younger people may qualify for Medicare. A person may also be eligible for Medicare benefits if they are receiving dialysis treatment.

There are two main types of Medicare coverage: Part A and Part B.

Part A covers things like surgeries, hospital stays, skilled nursing facility costs, and home health care. Part B includes outpatient services, such as visits with a primary care doctor. Additionally, you are able to add Part C coverage, called the Medicare Advantage Plan, or Part D coverage for prescription drugs.

Understanding Medicaid

Unlike Medicare, which is primarily for the elderly, Medicaid provides coverage to more than 80 million low-income persons. Both the federal government and the individual states fund Medicaid, with each state adopting a slightly different program.

In Washington, Medicaid does not pay money directly to those who qualify. Medicaid instead pays healthcare providers directly. Eligibility for Medicaid is primarily based on income and resources. In order to qualify, an individual adult up to age 64 cannot make more than $1,397 per month and must not be entitled to Medicare. Pregnant women, children, non-citizens, aged persons, and the blind and disabled may also all qualify for Medicaid if they meet income and resource requirements.

Dual Eligibility

While most people who qualify for Medicare will only benefit from Medicare and not Medicaid and vice versa, there are some people who maintain dual eligibility for both programs. If you have dual eligibility, it is likely that you will have little-to-no out-of-pocket healthcare costs since both programs fund these costs.

Understanding Your Benefits

It can be challenging to know whether or not you qualify for Medicaid or Medicare and how to apply for either or both. It can also be confusing to know exactly what each benefit type covers.

Before you start the application process, consulting with a knowledgeable professional about which benefits may be available. Our experienced legal team at the Elder Law Group PLLC can assist you in understanding Washington Medicaid and Medicare benefits and applying for them.

Do You Have Any Other Questions?

To schedule a consultation with our Washington elder law attorneys today, please call us directly or send us a message at your convenience. We can answer all of your questions.

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