Many people think that Medicare and Medicaid are the same thing. Actually, they are two very different programs. Some people qualify for both Medicare and Medicaid.
What is Medicaid?
Medicaid is a state-run program that provides hospital and medical coverage for people with low incomes and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid.
In our experience, Florida is not a very generous state when it comes to providing Medicaid coverage. Generally, coverage is provided to people with little income and few resources who also have minor children, and/or to people with little income and few resources who have various serious diseases and no other health coverage.
What is Medicare?
Medicare is our country’s health insurance program for people aged 65 or older. Certain people younger than age 65 can also qualify for Medicare, including those who have disabilities. The program helps with the cost of healthcare, but does not cover all medical expenses or the cost of most long-term care. People can buy a Medicare supplement policy (called Medigap) from a private insurance company to cover some of the costs that Medicare does not pay.
Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It is also financed in part by monthly premiums deducted from Social Security checks.
Medicare has four parts:
- Hospital insurance (Part A),
- Medical insurance (Part B),
- Medicare Advantage (Part C), whereby people with Medicare A & B can choose to receive all of their healthcare services through a provider organization (health insurance company), and
- Prescription Drug Coverage (Part D), which helps pay for medications doctors prescribe.
Who Can Get Medicare?
Medicare is primarily for people who:
- Are age 65 and older
- Are citizens or permanent residents of the United States
- Are eligible to receive Social Security or Railroad Retirement benefits
or
- People who have a spouse who receives or is eligible to receive Social Security or Railroad Retirement benefits.
Before age 65, you can also be eligible for free Medicare hospital insurance when:
- You have been entitled to Social Security disability benefits for 24 months.
In our practice we have found this to be a significant hardship for some people who cannot work and are approved for disability, but still cannot get private insurance. These people are not eligible to receive Medicare for the first two years after the Social Security Administration agrees that they are disabled.