The major difference between Medicare and Medicaid are most of the time confused especially because they sound quite similar, but the two programs are totally different from each other. There are proper set of rules in which both the Medicare vs Medicaid eligibility and cost are completely different and have their own policies and laws. Both the programs are specially designed in such a way so that they can be suitable for different set of people and for proper selection of correct program it is important to completely understand what Medicare and Medicaid is.
I. What are the Differences Between Medicare and Medicaid?
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One of the major differences between Medicare vs Medicaid is the age of the applicant because this is considered as one of the most acknowledged welfare programs which is specially designed for benefiting people having very limited financial resources. The other difference between Medicare vs Medicaid is the eligibility criteria which is specially designed to assist people having age 65 or older but in most of the cases these programs also help people suffering from the medical disabilities or severe diseases.
This program is sometime applied to a special member of a family or entire family members because both the programs are jointly run by the federal government and the state of US so the eligibility criteria is designed specially in such a way so that the people and their families can be supported in terms of medical care and financial resource
Additionally, you can also apply in both the programs depending on your current family situation because both the programs have open enrollment period where people can apply according to their family situation. As, both the programs have basic eligibility criteria which is extremely important to fulfill before considering yourself a legal applicant for these programs.
2. What is Medicare?
Medicare is known as a policy which is specially designed for the citizens of US having age over 65. It is specially designed for all those older people who face difficulty especially in covering their major expenses which are quite related to the treatment and medical care.
Mostly people also ask that, is Medicare better than Medicaid then the answer to this question is that both the programs are designed for special purposes and both have their own set of laws and regularity’s. Here in Medicare, the program provides complete support to all the senior citizens and their families in terms of not just the financial assistance but also the medical needs as well.
All those people having age less than 65 but suffering from disabilities can also apply for this program especially for the medical benefits but each case is specially evaluated on the basis of eligibility criteria and the basic requirements which are completely needed to fulfill the details of program. Those people suffering from the final stage of kidney disorders can also apply for this program to look for the benefits of medical policy.
How do I enroll in Medicare?
There are some of the basic requirements which are important to fulfill if you are looking to enroll in Medicare. These requirements are given below:
• One should be 65 years old or older and the most important thing is that the person applying for enrollment in Medicare should be the permanent U.S. citizen or resident who has been living in the country for at least five years.
• You also get the basic insurance of Social Security and disability especially if you are qualifying for a waiting period of Medicare.
• If you are suffering from final stage renal disease, then you can also apply for this program at any age. In some situations, you can be automatically enrolled in this program however if you are not enrolled in this program automatically then you can also look for other sign up options in different enrollment periods.
• The 1st and the most important period of enrollment in this program is the initial enrollment period which is about seven months. It gives you proper chance and starts from 65th birthday and the other enrollment program starts from October to December and you can also look for the sign up option in order to avail the Medicare Advantage plan but the major difference in Medicare vs Medicaid enrollment plan is the overall program qualifications.
If you’re experiencing any kind of certain life events, then you can also apply for the special enrollment period program of Medicare.
3. What are Medicare premiums and coinsurance rates?
The basic and the most important listing of the medical premiums which includes the deductibles and number of other coinsurances for Medicare program are given below:
1. Part A: (Hospital Insurance) Premium
If you buy the party program than initially you will have to pay about $411 after each month back in 2016 but for all those people having age 65 or above you can get free premium especially if you fulfill the following conditions:
• You are already getting the benefits after retirement from the Social Security board and you are also eligible for these benefits.
• You are currently enrolled in the government employment programs of Medicare.
• You are receiving 24-month benefits from retirement board disability.
• You are fulfilling the basic requirements along with suffering from the end stage renal disease.
2. Part B and Part D
All those people looking to pay for the part B program must pay $121.80 in 2016. It also includes number of other durable medical expenses. However, part D has some additional monthly premiums having other type of medical expenses.
4. What is Medicaid?
Medicaid is known as a program that combines the overall efforts of the United States and the federal government to provide assistance for households having very low income and have nothing to support their health care expenses for example the hospitalization and major treatments along with the routine medical checkups. The Medicaid eligibility and cost completely depends on the case, but this program is specially designed to help all those people who cannot afford their medical care and are suffering from financial problems.
One of the biggest questions which people generally confused is that what is the difference between Medicare and Medicaid so the answer to this question is that cost and eligibility is the major difference between both programs. The people receiving Medicare program benefits generally pay a special part of the cost through different deductibles a number of other necessity is just like the hospital stays and for their coverage outside the hospital for example the visit of doctor or preventive care.
This program provides special type of monthly premiums. Some out of the pocket things are also included in this program for example prescription drugs.
All those people receiving the benefits of Medicaid generally don’t pay for their covered expenses at all but in some cases, people are required to pay a small amount of copayment.
If you are looking to enroll in each program than there is a certain criteria which you must fulfill.
1. Who is eligible for Medicare?
If you are encountering this question that how I know if I have Medicare or Medicaid, then the most important thing to consider is that the eligibility criteria based on the age of the applicant. A person should be the citizen or permanent resident of United States and he or she should be over the age of 65 years to qualify the basic criteria. The major criteria for Medicare vs Medicaid also depend on these specific plans along with the premium plans which are specially designed to meet the eligibility criteria and completely depends on the Medicare taxes which have been paid by the applicant.
There is exception in eligibility criteria of Medicare vs Medicaid for all those people having age over 65 but are suffering from disabilities. Generally, for all those people who are receiving the benefits of Medicare also receives these Social Security benefits and these benefits are generally extended to a person eligible for the disability program of Social Security along with the age of 50 or older and also to a person or child who has been working a minimum length of time especially in the government job or the paid medical job.
2. Who is eligible for Medicaid?
The basic eligibility criteria for Medicaid completely depends on the income whether someone can qualify for the basic income level or family size. The affordable Medicaid Care Act has been extended to fulfill the basic healthcare gaps and especially for all those people having low income and are unable to support their family.
To find out that whether you are eligible for this program you must visit their online website to assess the basic requirements.
For majority of people having age over 65 the basic eligibility criteria depends on the income level which is about 133 percent of the overall federal poverty level and according to the health care this particular amount is approximated to about $14,500 for individuals and $29,700 for a family or four people.
Children have their own special type of criteria levels which is generally insured by the children health insurance program and is completely based on the state of residence. There are number of other special programs which have been initiated by this Medicaid program and now extended to group of people unable to fulfill their immediate needs.