medicaid-guide.org Explains the Differences Between Medicaid and Medicare

Health insurance is a luxury for many Americans. However, all Americans require at least partial health insurance coverage to support their medical needs. While private health insurance premiums can be expensive, federal- and state-funded programs offer health insurance coverage for those with limited access to health care, such as low-income households and retired beneficiaries. The two main government health insurance programs in the U.S. are Medicaid and Medicare. Although both programs provide medical aid to those who may otherwise not receive coverage, the programs differ in terms of their clientele, benefits and management. Not only must people be aware of the type of coverage each government health insurance program offers, but they should also know how the programs operate to best utilize the resources. The team at medicaid-guide.org understands the importance of these health insurance programs and has provided detailed descriptions of the two programs to enable patients to make an informed decision regarding their medical care.

Medicaid Services

Medicaid primarily serves low-income beneficiaries who have little to no access to proper health insurance. However, this service reaches participants with disabilities and children as well. Children and families may also qualify for the Children’s Health Insurance Program (CHIP), a subset of Medicaid offering supplementary childcare services. The Medicaid assistance program is organized and funded by local and state governments but follows federal regulations that promise Medicaid patients certain benefits and treatment such as the authorization for inpatient and outpatient hospital services, laboratory services and pediatric care coverage. Therefore, Medicaid services vary by state.

Medicaid Benefits

Due to differing state laws, some Medicaid benefits are not guaranteed to all Medicaid patients. For instance, occupational and physical therapies, prescription drug coverage and eyeglass insurance are optional benefits and depend on local health insurance protocols. These optional benefits may affect those with chronic illnesses or disabilities, the elderly and people with preexisting health conditions. The team at medicaid-guide.org recommends researching your state’s Medicaid programs to ensure you will obtain the benefits you require.

Medicaid Coverage

Coverage is determined based on the type of Medicaid health insurance you have. While some states fund Medicaid beneficiaries’ medical care directly, acting as an insurance provider, other states compensate private insurance companies to care for Medicaid patients. For basic Medicaid coverage in most states, participants pay only a small amount of out-of-pocket expenses after taking deductibles into account. Additional costs that patients may incur under Medicaid are most often co-payments, which are charged at medical offices prior to receiving treatment. All potential expenses are calculated and distributed according to each state’s Medicaid program. The team at medicaid-guide.org encourages patients to monitor their medical expenses and verify all costs with their Medicaid providers.

Medicare Services

Whereas Medicaid is a state-funded program that relies on state procedures, Medicare is a federal health insurance program, which means the federal government mandates its actions and manages its finances. The program functions as a retirement plan or as both a retirement plan and medical insurance, depending on a participant’s needs. Unlike Medicaid programs, Medicare is offered to recipients regardless of income. However, the program mainly supports those over 65 years of age and occasionally caters to younger disabled recipients or beneficiaries with kidney failure. Applicants may capitalize on a few types of Medicare plans within the Medicare program: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS) and Special Needs Plans (SNPs). These plans list medical professionals in the plans’ networks that Medicare patients must utilize. The Centers for Medicare & Medicaid Services organizes the program and sets standard guidelines, ensuring the program remains regulated throughout the U.S.

Medicare Benefits

As a federal-based program, Medicare’s benefits remain consistent in each state. Some benefits of Medicare services include preventive screening tests and retirement care, but the services may exclude long-term care. The team at medicaid-guide.org reminds you that the rate of these benefits may vary according to your Social Security plans and funds.

Medicare Coverage

The Medicare program operates via recipients’ Social Security or trust funds. However, candidates may request Medicare retirement services prior to turning 65 years of age and receiving Social Security benefits. The team at medicaid-guide.org informs everyone that delays and higher premiums may occur as a result of early enrollment. Medicare charges small monthly premiums for non-emergency health insurance coverage and will require you to pay some costs through deductibles. Although costs do not vary by state policies, out-of-pocket costs are determined by your individual Medicare plans and Social Securities.

Joint Coverage

Those who qualify for both Medicaid and Medicare coverage may apply both health insurance programs to receive the medical coverage from each program. This would allow recipients to benefit from services such as Extra Help Program to help with prescription drugs costs. However, Medicare would serve as the primary provider for those with Medicaid and Medicare.