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Medicare vs. Medicaid Plan: A Comprehensive Review and Comparison

Medicare vs. Medicaid Plan

Medicare and Medicaid are two health insurance programs covering almost 100 million Americans. That’s a massive number, isn’t it? Although these two programs sound the same, they are completely different. Let’s unpack their differences and take you through the comparison of the Medicare vs. Medicaid plan.

Medicare vs. Medicaid Plan: The Basics

Medicare and Medicaid are both government-owned programs, providing health coverage to millions of coverages. However, both differ in the coverage allowances, eligibility criteria, and costs.

Medicare is, in fact, a federal program providing health coverage to people aging 65-year-old individuals. On the other hand, Medicaid is a state and federal program that provides health coverage to low-income families. Let’s discuss the eligibility in more detail.

Eligibility Criteria

Medicare is not only restricted to people aging 65 or more. In addition, it can be extended to:

  • Individuals aging 50 or more and receiving disability benefits
  • A government’s officer children, provided he/she duly paid taxes
  • Individuals diagnosed with ALS and ESRD

Medicaid, on the other hand, has minimum income requirements varying according to state. If your income falls below the poverty level as per your state guidelines, you can qualify for it. Usually, the eligible income level for Medicaid is 133% lower than the federal poverty level.

Moreover, Medicaid has special programs that extend coverage to certain individuals, such as pregnant women and people with challenging medical needs.

Medicare vs. Medicaid Plan Coverage Benefits

Medicare has specific parts: Part A and Part B. Part A usually covers hospitalization services, while Part B deals with outpatient coverages. Moreover, there are Medicare advantage plans (type C) which provide Type A, Type B, and any additional coverage in a consolidated single plan.

Prescription Medication coverage (Type D) is another essential prescription plan and sells separately from Original Medicare. However, some Medicare Advantage plans can provide Part D coverage as well. You can also have Medicare savings account with a Type C health plan.

On the other hand, Medicaid coverage benefits vary from State to State. However, it offers plenty of valuable services such as hospitalization, clinic treatment, doctor and lab services, nursing, and midwife services. However, states can add more coverage options such as prescription, dental, vision, and therapy services. Sometimes, Medicaid can even support long-term care, which is not an option with Medicare.

Medicare vs. Medicaid Plan Costs

Medicare only has a premium cost for Type B. However, it can have massive deductibles (in the case of Type A), and Medicare covers only 80% of total services. You have to pay the rest 20% in the form of coinsurance.

Moreover, if you’re a social security recipient, you are saved from rising premiums per the Medicare hold harmless provision ruling. In contrast, Medicaid recipients don’t have to pay for healthcare services. Even if they do, it’s in the form of low copays, i.e., usually $50. States can also charge limited premiums to certain people, especially pregnant women, and disabled individuals with a household income 150% above the poverty line.

Parting Thoughts!

After this holistic comparison of the Medicare vs. Medicaid plan, you should have a clear view of what to expect from each program. If you want to enroll in a health plan, get your customize quotes from New Medicare.

Reach out and accept Medicare plans today!

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