What’s the Difference Between Medicare and Medicaid?

Medicare and Medicaid are two programs enacted by the federal government. However, Medicaid is administered at the state level. Both of these insurance plans were created in 1965 by the Johnson administration. These programs are designed to provide healthcare coverage to people who meet certain eligibility guidelines.

Each program has its own benefits, and it’s important to understand how these insurance plans work so you can take ownership of your health.

Eligibility Requirements

In order to qualify for Medicare, you must be at least 65 years of age. Medicare has many sub-components and is available to you as a portion of what you paid as a worker or taxpayer.

Medicaid’s eligibility is income-based. People with a very low income may qualify for Medicaid. People who are both low-income and over the age of 65 may qualify for dual-eligibility to both of the insurance plans, with the programs working together to provide healthcare coverage.

Open Enrollment

Medicare has a specific open enrollment, which takes place each year in the fall. If you already have a Medicare insurance plan, you can change your enrollment at that time. There is no open enrollment for the Medicaid insurance plan. You can apply for the program any time you think you’re eligible.

Financing Your Health Insurance

Medicare is funded through payroll taxes that workers and taxpayers have paid during their working years. The amount you paid as a worker determines the portion of Medicare coverage you will receive. On the other hand, Medicaid is funded jointly by the federal government and the states. Since Medicaid is income-based, your eligibility for the program is determined by your income level. If your income is low, you may qualify for Medicaid and receive healthcare coverage accordingly.

Healthcare Coverage

Medicare coverage is the same no matter where you live. Your healthcare coverage depends on the plan you choose. Medicaid healthcare coverage is determined by the state in which you live. A state can choose whether or not to cover health needs such as dental care, chiropractic care or vision care. Medicaid has mandatory benefits such as hospitalizations and visits to your family doctor. Each state sets its own optional coverage.

See if any of these health insurance plans could benefit you.