Most Americans confuse Medicare and Medicaid programs for each other with such similar names or believe the programs are just as related to their names. Although both are government-run programs, however, there are several significant differences.

A doctor holding a toy heart in her hand as she holds it in front of her

What is Medicare?

Medicaid is an aid scheme. It is meant to provide health coverage for individuals below a certain level of assets and incomes, which Medicaid would find deprived. This represents people of all ages but is checked by tools.

Medicaid is also a federal-state program, which ensures funding and guidelines are given by the federal government, but the program itself is implemented at the state level.

The qualification and administration rules can differ somewhat from one state to another.

In its essence, Medicaid is intended to provide those who would otherwise go uninsured due to a lack of resources with a health care safety net.

What is Medicaid?

Medicare works similar to an insurance system. Also called an entitlement since it is paid in during your lifetime, Medicare makes payments during your professional career on behalf of a participant from trust funds, which the participant has paid in through their payroll deductions.

Medicare mainly serves those 65 and older, irrespective of their age, but it can also support people with disabilities under 65.

Participants also pay for health facilities with a co-payment and sometimes use an additional health insurance policy to fill the gaps in Medicare. Medicare is a service under the federal program

Difference between Medicare and Medicaid

Medicare and Medicaid are two different programs run by the Government.

These are run and supported by different parts of government and mainly benefit various groups.  Generally, the similarities between Medicare and Medicaid can be distilled down to who manages them, who benefits, how much users pay and what programs they provide. 

The key differences are provided below:

  • People receiving Medicare coverage pay a part of the cost for issues like hospital stays by deductibles. Medicare needs small monthly payments for services outside the hospital, such as visiting a doctor or taking preventive care. Many out-of-pocket costs may also apply to things like prescription drugs while people who receive Medicaid coverage often do not have to pay for covered costs at all, but in some situations, a minor copayment is required.
  • Reimbursements for the medicare come from a federal trust fund. Most of that fund’s money comes from payroll taxes. Furthermore, premiums, deductibles and copays help pay for Medicare benefits. In the case of Medicaid, it is similar but many of the details, including reimbursement rates, vary by state. Doctors may choose not to consider Medicaid in situations where the reimbursement rate is much lower than the cost of the treatment. This is sometimes true in Medicare, too.
  • Disabled people and some members of their family can receive Social Security Disability Insurance benefits. The program includes Medicare yet there is a 24-month wait period in some cases before it begins. You also have to have worked and paid taxes on Social Security to apply. The SSI program includes Medicaid which allows payments for cash assistance to eligible disabled people with limited income.

Medicare, Medicaid and Estate Planning

Estate planning is highly essential to ensure you are eligible for the Medicare and Medicaid health programs when you get old and avoid putting a negative impact on your estate.

It’s normal for older people to think about their medical care over the long term and start making plans.

As far as Medicaid planning is concerned, the conversation centers on the potential incompetence of the aging person and the negative impact other members of the family may have on him.

The aim of the preparation is to protect the estate of the elderly person as much as possible, without impacting their eligibility for long-term Medicaid medical care.

For anyone looking for long-term care coverage, the first move is to gain a deep understanding of the legal landscape and learn the basics of the programs available to pay for long-term healthcare.

Long term planning is something everyone needs to do, and it’s important to work with experts like the Finity Law Firm to ensure it’s done right.

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