What Is the Difference Between Medicare and Medicaid?

Getting the medical care you need is essential, but it isn’t always easy. For those who don’t have private insurance, Medicare and Medicaid are two government-run programs that are designed to help people to be able to afford most types of medical care throughout their lives.

While they have similar names, these two programs are quite different and are available to different—though sometimes overlapping—groups. Understanding the difference between these two programs can help you to determine which one you might qualify for so you can get the care you need.

What is Medicare?

Medicare is a program offered by the federal government (though often managed by individual states) that offers health coverage for people who are 65 years old or older. Those with severe disabilities that prevent or severely inhibit the ability to work can also qualify for this program. There are no income limits associated with this program.

What is Medicaid?

Medicaid is a program that is offered by a combined effort between individual states and the federal government. The program is designed to help people with very low income to get the health care that they need, including seniors and those with disabilities. In the state of Florida, the income restrictions are based primarily on the modified adjusted gross income of the individual or family, and qualifying for this program means that the person makes less than a certain percentage of the federal poverty level. That percentage changes based on the age of the person (including children), whether the individual is pregnant, and more.The income and other qualifications for Medicaid in a nursing home are totally different than the qualifications for other Medicaid programs.

Dual Eligible

Once reaching retirement age, some people find that they are eligible for both of these programs. If you meet all the requirements of both programs, it is possible to become dual enrolled, and enjoy the benefits of both. This can help to ensure you get excellent health care throughout your golden years.

Medicaid for a nursing home is called Medicaid-ICP (Institutional Care Program). Medicaid can cover the cost of assisted living facilities for those who qualify, but there is a waiting list in any event. That is because by law Medicaid has to fund ICP, but Medicaid does not have cover the cost of assisted living facilities. Planning one’s financial situation specifically to ensure Medicaid will be available for assisted care facilities and nursing homes is often a very smart part of retirement planning.

Help Getting the Medical Care You Need

If you are finding yourself in a position where you don’t have the health care you need, it may be possible to qualify for one of these two programs. Even if you have been rejected from them in the past, we may be able to help you get enrolled successfully. Our team has years of experience helping people to plan for and enroll in Medicare and Medicaid, so please don’t hesitate to call Proactive Legal Care today.

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