Unless you know a lot about government-run programs, it is easy to conflate Medicare and Medicaid. However, the terms aren’t interchangeable and refer to completely separate things. Here is an overview of the differences between Medicare and Medicare.
What Is Medicaid?
Medicaid is a health insurance program that is run by the state and federal governments. It is intended to provide medical coverage for very low income individuals and families. Medicaid started in 1965, though the program has changed quite a bit over the past few decades.
Medicaid eligibility depends on where you live, as the criteria varies by state. In Florida, the maximum income for Medicaid eligibility for a household of one is around $16,000 a year, at the time of this writing. However, pregnancy, having a blind family member, or having dependents can change who is eligible for the program.
What Is Medicare?
Medicare is a federal health insurance program seniors age 65 years old and older. You can also get Medicare if you’re under 65 years old and have a permanent disability. Unlike Medicaid, there are not any income restrictions in place to be involved in the program. However, there is a cost of living adjustment that can impact some high-income earners. Medicare Part D is for prescription medication coverage. Part A and Part B provide hospital and outpatient medical coverage, respectively. Part C is where Medicare Supplements or Medicare Advantage plans combine to help offset costs not picked up by Parts A and B.
Medicare Supplement Plans
Medicare supplement plans are in addition to your Original Medicare plan. These plans often have a monthly premium on top of Original Medicare premiums and are intended to help reduce the out of pocket expenses associated with Medicare. You will still get to keep your existing Original Medicare benefits. This can be extremely advantageous for seniors who have a lot of medical expenses to manage or that want a lower annual out of pocket expense. Medicare Supplement Plans have easy to manage plan designs, lower annual out of pocket expenses, and nationwide provider networks.
Medicare Advantage Plans
Medicare Advantage Plans are provided by a private insurance company. Sometimes this is referred to as Medicare Part C. Instead of receiving Medicare through the government, the government pays the health insurance provider on your behalf. You get coverage through the Medicare Advantage Plan instead of Original Medicare. The details and specifics of each plan vary. You can opt to get a PPO, HMO, or other care plans as a Medicare Advantage Plan. Some plans will not cost you anything in terms of a premium, whereas others you’ll need to pay an extra fee for the added coverage.
It is possible to have both Medicaid and Medicare, if you qualify for both. The plans will work together to reduce the cost you have to pay for care. Depending on your specific medical needs, this can make a difference in how much you can expect to pay for care each year.
Navigating government insurance programs can be confusing and overwhelming. Call (813) 454-5072, anytime to speak with one of our team members at the Norgard Insurance Group. We’re happy to spend time answering any questions you may have about these programs, as well as to provide you with insurance solutions that can help.