Medicare Vs. Medicaid

Medicare and Medicaid are government-run health insurance programs that can be confused with one another. While they have some similarities, the two differ in terms of what they cover and whom they cover. However, it is essential to understand how these programs work and when you or your loved ones might benefit from one or the other.

Medicaid is a state-run program that provides health insurance to people making below certain income levels. Because the states run Medicaid, the rules governing eligibility vary from state to state. Medicaid typically covers hospital expenses, prescription drugs, doctor’s visits, and laboratory fees, to name a few, as well as certain non-medical costs such as home care assistance, transportation to medical appointments, and home modifications.

On the other hand, Medicare is run by the federal government and provides health insurance to millions of American seniors (65 and older). Medicare is also available to individuals of any age with certain qualifying medical conditions such as end-stage renal failure. The Medicare program consists of four components, which are:

A. Hospital Coverage – Pays for hospital stays and inpatient care

B. Medical insurance- Pays for doctor visits and outpatient care

C. Medicare Advantage Plans- Combines A & B into one plan that includes prescription drug coverage.

D. Prescription drug coverage

Individuals may also be dual-eligible for both Medicaid and Medicare. Please contact your state’s Medicaid office (in PA, it is the Department of Human Services 1-800-692-7462) to see if you are eligible for Medicaid. For questions about Medicare, call 1-800-MEDICARE (1-800-633-4227).