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Medicare vs. Medicaid Comparison Chart

Outlined below are further differences between Medicaid and Medicare.

                               Medicare

What is it?
A federal health insurance program for people who are:

  • 65 or older
  • Under 65 with certain disabilities
  • Of any age and have End Stage Renal Disease or ALS

 

Who governs it?
Federal government

 

What does it cover?
Depends on the coverage you choose and may include:

  • Care and services received as an inpatient in a hospital or skilled nursing facility (Part A)
  • Doctor visits, care and services received as an outpatient, and some preventive care (Part B)
  • Prescription drugs (Part D)

Note: Medicare Advantage plans (Part C) combine Part A and Part B coverage, and often include drug coverage (Part D) as well - all in one plan.

 

 

What does it cost?
It depends on the coverage you choose. Costs may include premiums, deductibles, copays and coinsurance.

 

How do I get it?
Many people are enrolled in Parts A and B automatically when they turn 65. You can also contact your local Social Security office to see if you are eligible.

Medicaid

What is it?
A joint federal and state program that helps pay health care costs for certain people and families with limited income and resources. Different programs under the Medicaid umbrella are designed to help specific populations.

 

 

Who governs it?
State governments

 

What does it cover?
Each state creates its own Medicaid programs, following federal guidelines. There are mandatory benefits and optional benefits. Mandatory benefits include, in part:

  • Care and services received in a hospital or skilled nursing facility
  • Care and services received in a federally-qualified health center, rural health clinic or freestanding birth center (licensed or recognized by your state)
  • Doctor, nurse midwife, and certified pediatric and family nurse practitioner services
  • And more

 

What does it cost?
It depends on your income and the rules in your state. Costs may include premiums, deductibles, copays and coinsurance. Certain groups are exempt from most out-of-pocket costs.

 

How do I get it?
Eligibility depends on the rules in your state. Call your State Medical Assistance (Medicaid) office to see if you qualify.