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Medicare VS Medicaid: What is the Difference?

Posted by Eskaton on Jan 7, 2016 3:36:19 AM

by Mallory Tomei, Eskaton's Information and Resource Specialist

“Do you know if you have Medicare or Medicaid?” asks the receptionist at the doctor’s office as she looks at you across the counter. She is patiently awaiting an answer, but you can’t remember which one you have. Many people experience this confusion when they are asked about insurance.

The terms are so similar it is hard to tell them apart. Medicare and Medicaid are two different government-based insurances. Although largely similar, they have a subtle differences.

Here is some information to help you understand these differences:

Medicare

Who is it for?

  • People 65 & older
  • Under 65 with certain disabilities
  • Anyone with End Stage Renal Disease (ESRD)

Who governs it? The Federal government

What is covered?

  • Care received in a hospital or skilled nursing facility
  • Doctor visits
  • Prescription Drugs

What do I pay?

Some premiums, deductibles, copays and coinsurance.

How can I sign up?

Most are automatically enrolled when they turn 65, but check with your local Social Security office before you turn 65.

 

Medicaid

Who is it for?

Individuals and families with limited incomes.

Who governs it? Individual State Governments

What is covered?

  • Care received in a hospital or skilled nursing facility
  • Care received in a federally-qualified health center
  • Doctor and nurse practitioner services

What do I pay?

  • Some premiums, deductibles, copays and co-insurance.
  • Some groups are exempt from most out-of-pocket costs.

How can I sign up?

Eligibility depends on which state you live in. Please contact your State Medical Assistance office.

Don’t forget—some people may qualify for both, and that would make remembering which one they have a lot easier! But for those who have one or the other, hopefully this chart will make the subtle differences a bit easier to understand. If you have any questions about enrolling for Medicare, Medicaid, or anything else, please call our Information & Assistance hotline Monday-Friday from 8-5.

916-334-1072 or 866-684-6554

www.eskaton.org

Topics: Information & Assistance

The Sacramento region is home to Eskaton, a nonprofit senior care provider offering innovative housing, healthcare and social services. Every day thousands of older adults enjoy retirement at our independent senior living communities and receive the care they need through assisted living, skilled nursing, memory care, rehabilitation and in-home care programs. With five decades of experience and a national reputation for innovation, Eskaton is Transforming the Aging Experience.