Have you ever wondered what’s the difference between Medicare vs Medicaid? If so, you’ve come to the right place. Let’s take a closer look at what they are, what they cover, and how they can help.
What is Medicare?
Medicare is a federal program designed for American citizens who are 65 and above. In addition, some private insurance companies also provide Medicare services.
Eligibility Criteria of Medicare
Although Medicare is given to individuals who are 65 and above, there are exceptions are made for individuals suffering from specific conditions or disabilities. This includes individuals who have End-Stage Renal Disease or Amyotrophic Lateral Sclerosis. In addition, individuals below 65, who are currently receiving Social Security Disability Insurance, might also be eligible for Medicare, especially if they’ve been receiving it for more than two years.
What Medicare Covers
Medical coverage includes trips to your physician, services provided by healthcare professionals, and other specialists that accept Medicare. Do note, there is usually a deductible that must be paid before Medicaid covers the rest of your medical expenses. There are also four different areas where Medicare coverage can be used. These are:
- Hospital Insurance: This includes inpatient expenses and the cost of nursing facilities.
- Medical Insurance: This includes outpatient care, doctors’ visits, medical supplies, and more.
- Prescription Drug Coverage: This covers the cost of prescription drugs.
- Medicare Advantage Plans: This is a specific form of Medicare provided by private companies and includes the benefits of hospital insurance, and medical insurance. It can also cover prescription drug coverage.
What is Medicaid?
Similar to Medicare, Medicaid is a form of state-run health coverage given to American citizens. With Medicaid, you can receive health care services and programs at low or no cost. Medicaid is the most relevant form of health coverage for older adults, as it covers long-term care expenses, such as nursing facilities. This is in contrast to Medicare, which only covers short-term nursing care up to 100 days.
Eligibility Criteria of Medicaid
Compared to Medicare, Medicaid covers different eligibility groups. People who qualify for Medicaid include:
- Children
- Low-income adults
- Disabled individuals
- Pregnant women
- Individuals who are 65 and older (and meet asset and income limits based on state regulations)
What Medicaid Covers
Medicaid covers a wide variety of services and health expenses. However, it is important to keep in mind that the coverage of Medicaid and Medicare can differ based on different factors, including state regulations and laws.
Medicaid benefits can cover the expenses of:
- Outpatient hospital services
- Inpatient hospital services
- Home health services
- Physician services
- Nursing facility services
- Prescription drugs
Medicaid and Medicare can help a lot in terms of managing healthcare expenses and services. If you’re wondering whether your Medicaid covers living communities, the answer is: maybe. Each state has different benefits and degrees of flexibility. Thus, residents in some states will be able to use Medicaid to help cover assisted living costs, including memory care programs.
To find out if your healthcare benefits can cover the cost of assisted living at Aston Gardens At The Courtyard, you can contact us at 813.633.2378. Our friendly team will be able to answer your questions and tell you more about the living options.
