Established in 1965 as amendments to the federal government’s Social Security Act, Medicare and Medicaid have both been providing much-needed healthcare services to millions of Americans each year for over five decades. However, while the two program’s names are similar, there are very real differences between them. As to how they differ for patients, here are some of the most important ways.
Income-based vs. Age-based
Perhaps the biggest difference between Medicare and Medicaid is their eligibility requirements. For Medicare, the program is age-based and generally open to people age 65 or older, although people with certain medical conditions who are under age 65 may also qualify. As for Medicaid, the program is based on an individual or family’s income, and there is no age requirement associated with the program.
Enrollment Periods
When you are wanting to enroll in Medicare, you will be able to do so usually only during specified enrollment periods that occur throughout the year. However, if you are wanting to enroll in Medicaid, there are no specific enrollment period requirements, meaning you can enroll in the program at any time.
Dental and Vision Care
When you enroll in Medicare, Parts A and B do not in most cases cover dental services such as tooth extractions, fillings, and other related services. However, Medicaid covers preventative dental care for adults as well as children. Also, Medicaid will cover eye exams and glasses, while Medicare Part B will cover only a basic vision test. In trying to decide what is best for you, utilizing Medicare Advantage solution software can offer detailed information on eligibility and services.
Dual Eligibility
While most people believe an individual can be enrolled in only Medicare or Medicaid, the fact is you can be enrolled in both services at the same time. Known as dual eligibility, this situation usually applies to older individuals who have very low incomes or other health situations requiring additional assistance. If you are eligible for both programs, you should take full advantage of your situation, since both Medicare and Medicaid will work together to help lower your healthcare costs and provide you with as many services as possible.
Due to Medicare being exclusively a federal program and Medicaid being one that is run by both state and federal governments, always make sure you are fully aware of what benefits and services to which you are entitled upon your enrollment. By doing so, you and your family can get the healthcare coverage and other benefits you need.
