Medicare and Medicaid are two healthcare insurance schemes that prevail in the United States of America. The motive behind such programs is ensuring healthcare is accessible for older, disabled, and poor folks.
The Medicare program helps with the healthcare costs for those Americans who are disabled and above the age of 65. On the other hand, the Medicaid program helps with healthcare costs for people with a meager income.
- Medicare is an insurance program run by the Federal Government of the United States of America. Since Federal Government runs it, this program stays the same in every state of the USA.
- People enrolled in this program must pay small amounts, which is more than the Medicaid Programs.
- It provides almost free healthcare to senior and disabled citizens.
- Medicaid is a social welfare program the State Government of the USA runs.
- Since the State Governments of the USA run it, this program differs from state to state in the United States.
- People enrolled in this program have to pay little to no amount.
- It provides free healthcare to citizens having meager incomes.
Comparison Between Medicare And Medicaid
|Type of program||It is a type of Insurance Program.||It is a type of Assistance Program.|
|Run By||The federal government of the United States of America runs it.||The state governments of the United States of America run it.|
|Focuses on||The federal and state governments of the United States of America fund it.||The federal government of the United States of America runs it.|
|Types||It is categorized into two parts, i.e., Original Medicare and Medicare Advantage.||It has no type.|
|Funding||It focuses on people over the age of 65, people with disability, or people with ALS and ESRD.||It is funded by the federal and state governments of the United States of America.|
|Rules and Regulations||The Rules and Regulations of Medicare are the same all over the country.||The Rules and Regulations of Medicaid vary from state to state.|
Major Differences Between Medicare And Medicaid
What exactly is Medicare?
Medicare is an insurance program started on July 30, 1965, and run by the federal government of the United States of America.
This program aims to provide free healthcare to people over 65 who are disabled or with end-stage kidney disease. Hospital Insurance Trust Fund and Supplementary Medical Insurance Trust Fund fund this insurance program.
This program is divided into two categories, i.e., Original Medicare and Medicare Advantage. These two categories are further divided into four categories, i.e., Part A, B, C, and D.
What exactly is Medicaid?
Medicaid is a social welfare or assistance program started in July 1965 that the state government of every state runs in the United States of America.
Due to this reason, the rules and regulations of this program vary from state to state. Medicaid aims to provide free healthcare to people with a meager income. The State and Federal governments of the USA fund this program.
Features of Medicare
- Insurance Programme.
- Ran by the federal government of the USA.
- Rules and Regulations stay the same all over the nation.
- Provides healthcare support to Senior and disabled citizens.
- Funded by Hospital Insurance Trust Fund and Supplementary Medical Insurance Trust Fund.
Contrast Between Medicare And Medicaid
- Medicare – Medicare is an Insurance Programme that aims to provide healthcare help to senior citizens in the United States of America.
- Medicaid is an Assistance Programme that aims to provide healthcare help to people with a meager income.
Type Of Programme
- Medicare – Medicare is a type of Insurance Programme.
- Medicaid – Medicaid is a type of Assistance Programme.
Provides Help To
- Medicare – Medicare provides healthcare help to seniors and people with disabilities or end-stage kidney disease.
- Medicaid – Medicaid provides healthcare help to people having low incomes.
- Medicare – The eligibility criteria of Medicare demand a person to be a US citizen or someone living in the US for more than five years. He should be 65 years old.
If someone is applying for disability, they should receive disability benefits for at least two years. If someone suffers from ALS or End Stage Renal Disease, they immediately become eligible for Medicare.
- Medicaid – The eligibility criteria of Medicaid only consider a person’s income. Since Medicaid varies from state to state, it is up to different states on what they consider low-income.
The income criteria are largely based on MAGI (Modified Adjusted Gross Income). Apart from the income, a person should be a US citizen or have lived in the US for more than five years to be eligible for Medicaid.
- Medicare – Medicare benefits include Hospital & Nursing Facility care, Hospice care, Home care, therapies, doctor’s appointments, labs & scans, Mental Health care, prescribed drugs & medicines, dental care, vision care, hearing care, etc.
- Medicaid benefits include Hospital & Nursing Facility care, Home Health care, prescription drugs & medicines, dental care, vision care, podiatry care, optometry care, speech & hearing care, labs & scans, hospice care, etc.
- Medicare – The Hospital Insurance Fund Trust and the Supplementary Medical Insurance Trust Fund fund the Medicare program.
- Medicaid – The federal and state government of the USA funds the Medicaid program.
Rules And Regulations
- Medicare – The rules and regulations of the Medicare program stay the same nationwide.
- Medicaid – The rules and regulations of the Medicaid program vary from state to state.
- Medicare – Medicare is further into Original Medicare and Medicare Advantage, which are divided into two parts.
- Medicaid – There are no sub-types of Medicaid.
- Medicare – Medicare generally involves higher costs in the form of premiums.
- Medicaid is generally free; however, if someone receives social security benefits, they might have to pay a premium.
- Medicare – Generally, a person has to enroll in this program three months before turning sixty-five.
- Medicaid – Enrolments in this program are open all the time.
Medicare and Medicaid are two programs started in July 1965 to provide almost free healthcare to senior citizens and those with lower incomes.
The major difference between Medicare and Medicaid is that the former is an insurance program while the latter is an assistance program.
Medicare focuses on providing healthcare to senior citizens, whereas Medicaid focuses on providing healthcare to those with a lower income.
Medicare Is Categorized Into Two Main Categories –
- Original Medicare – The Federal Government of the USA provides Original Medicare. It comprises two separate parts, i.e., Part A and Part B.
- Part A concerns inpatient services offered to patients in Hospitals and Nursing facilities. It is also referred to as Hospital Insurance.
- Part B of Original Medicare aims to provide secondary healthcare services such as Doctors’ appointments, therapies, counseling, labs, scans, etc. It is also referred to as Medical Insurance.
- Medicare Advantage – Private Insurance companies provide Medicare Advantage. Like Original Medicare, it consists of two parts, i.e., Part C and Part D.
- Part C – This Part C provides mixed benefits of Part A and B Medicare and additional benefits like medicines coverage and dental and vision benefits.
- Part D – Part D is known for providing the prescribed medicines and drugs to the patient. It should be noted a person cannot have Part C and D altogether. If a person has Part C, he can not apply for Part D, as Part C already covers medicines and drugs.
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Frequently Asked Questions (FAQs)
Q1. What are the eligibility criteria for Medicare and Medicaid?
Following are the eligibility criteria for Medicare and Medicaid
The common eligibility criteria of Medicare and Medicaid
A person should be a citizen of the United States of America or should be a certified US non-citizen living in the USA for more than five years.
Unique Points of Criteria for Medicare
A person should be 65 or older.
A Disabled person is receiving disability benefits for at least 24 months.
A person should have ALS (Amyotrophic Lateral Sclerosis) or ESRD (End Stage Renal Disease).
Unique points of criteria for Medicaid
Q2. Can you have Medicare and Medicaid both?
Yes, it is possible to have Medicare and Medicaid, but a person must be eligible for both in such a case.
Q3. What are the major differences between Medicare and Medicaid?
The following are the major differences between Medicare and Medicaid.
1. Medicare is a type of Insurance Programme, whereas Medicaid is a type of Assistance Programme.
2. The Rules and Regulations of Medicare are the same all over the country, while those of Medicaid differ from state to state.
3. Medicare focuses on the Senior and Disabled population, while Medicaid focuses on low-income people.
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