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What's the Difference Between Medicare and Medicaid?

Discover the differences between Medicare and Medicaid, including eligibility requirements.

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Both Medicare and Medicaid are government-funded programs that caregivers should know about. To decide which one is right for you, you’ll want to understand the main differences between them.

Chances are you’ve heard of Medicare and Medicaid.

Funded by the government, these U.S. healthcare programs give medical coverage to people who qualify. 

But here’s the thing. While both Medicare and Medicaid help Americans access affordable care, the programs are very different. Let’s examine what they are, who is eligible, and how these programs differ. 

What Is Medicare?

Medicare is a federal health insurance program. It provides health coverage to people 65 and older, as well as those with certain disabilities, ALS (or Lou Gehrig’s disease), and permanent kidney failure.

Medicare coverage is divided into four parts, including:

  • Part A

Medicare Part A is hospital insurance. It covers inpatient hospital stays, hospice care, and skilled nursing facilities. It also covers home healthcare after a hospital stay of more than 100 days.

  • Part B

Medicare Part B is medical insurance. It covers outpatient services like doctor visits, lab tests, and preventive care. Caregivers from a Medicare-certified agency are generally covered here too.

  • Part C

Medicare Part C is also known as Medicare Advantage. This is an alternative to traditional Medicare and includes added benefits like vision and dental care.

  • Part D

Medicare Part D is prescription drug coverage. Coverage extends to a number of vaccines as well. Private insurance companies usually manage the plans that offer Part D coverage.

Medicare is mainly funded by payroll taxes and general government revenue, and beneficiaries pay their own premiums. Most people automatically qualify for Medicare when they turn 65. 

What Is Medicaid?

Medicaid is a joint federal and state program. It offers healthcare coverage to low-income people and families, and to qualifying pregnant women, children, and those with disabilities. 

Medicaid eligibility is based on income and a number of other factors. The program covers a range of medical services, including: 

  • Hospitalization
  • Physician services
  • Laboratory and X-ray services
  • Preventative care

In many cases, Medicaid also covers the cost of home care—including family caregivers who qualify. 

Note that each U.S. state has its own rules for Medicaid eligibility, coverage, and cost-sharing via copayments and deductibles. Some states have expanded their Medicaid programs under the Affordable Care Act, which provides coverage to even more low-income adults.

How Are Medicare and Medicaid Different?

One of the main differences between Medicare and Medicaid is eligibility. We discussed the eligibility requirements above. Medicaid eligibility, however, is especially confusing.

This is because to qualify for Medicaid, you need to meet your state’s income and resource (or asset) requirements. If you earn more than the maximum income for Medicaid, you won’t qualify. Similarly, if your assets are worth more than what Medicaid allows, you won’t be eligible for coverage. 

Medicaid eligibility requirements vary by state. Family caregivers should check their state’s requirements to determine their loved one’s eligibility. It’s also important to consider that some people who qualify for Medicaid won’t qualify for Medicare. The opposite is true as well.

Another key difference between the programs: Medicare usually only covers short-term stays in skilled nursing facilities after the patient has been hospitalized. Medicaid, however, covers long-term care services and support. In fact, it’s the biggest source of long-term care funding in the U.S. 

This makes the program especially appealing to family caregivers and their loved ones. We want to help you navigate it.

Family Caregiving Compensation with Aidaly

Earning money as a family caregiver is possible—including through programs like Medicare and, more often, Medicaid. Aidaly will help guide you through this process and make sure you have access to the right resources and training. 

Please contact us for details, and check your eligibility for family caregiver compensation today.

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