Medicare and Medicaid are two essential ways that people obtain health coverage and other important financial coverage. But, because they are both government health insurance programs and sound similar, it can be hard to remember which is which. If you or your loved one is planning for their golden years in Florida, it is important to know the differences in Medicare and Medicaid.

What is Medicaid?

Medicaid is a government program that operates jointly between the federal government and the state. The purpose of Medicaid is to help with medical costs for those who qualify based on limited income. The reason it is a joint federal and state program is that the federal government has general rules that all states must follow, however, each state is responsible for running its own program. Coverage for people here in Florida may differ from those in other states.

Medicaid Eligibility, Costs, and Benefits

As mentioned, the Medicaid programs in each state differ and, they can change each enrollment period. If you are interested in considering the eligibility requirements in Florida you can view the current standards here. If an individual is eligible for Medicaid, they will have no out-of-pocket costs for covered services. This includes inpatient and outpatient hospital care, doctor visits, prescription drugs, preventive care, diagnostic, and screening services, and coverage for nursing home facilities.

Upon the 65th birthday, individuals who are eligible for Medicaid can then become dually eligible for both Medicaid and Medicare.

What is Medicare?

Medicare is a federal government health care program. The purpose of Medicare is to provide health insurance for individuals 65 years of age or older regardless of household income, as well as people under age 65 who have certain conditions or disabilities. Unlike Medicaid, where health care costs and coverage may vary from state to state, Medicare coverage is the same in every state.

The 4 Parts of Medicare

Medicare is a broad term that covers four plan options for medical care that may be needed. Note, Medicaid Parts A and B are often referred to as “Original Medicare.”

  • Medicare Part A: Hospital insurance or inpatient care

  • Medicare Part B: Medical insurance or outpatient care

  • Medicare Advantage Parts C: Voluntary private insurance

  • Medicare Part D: Private prescription drug coverage

Can I Have Medicaid and Medicare at the Same Time?

Yes! A person who has both Medicaid and Medicare for health care needs is known as being “dual eligible.” When this occurs, Medicare is typically the primary health insurance with Medicaid providing subsidized benefits through Medicare Savings Programs.

Medicaid and Medicare are similar to one another in both name and purpose but they also have some key differences regarding age, income eligibility, state differences, etc. If you or your loved one are seeking to understand how Medicaid and/or Medicare may be able to help you obtain the healthcare coverage you need, contact our knowledgeable elder care lawyers today.