What is Medicaid Medicare? Complete Guides on Medicare, Medicaid
What is Medicare? What is Medicaid?
Revised February 2019 – Credit – https://www.medicare.gov/
Medicare is health insurance for:
- People 65 or older
- Certain people under 65 with disabilities
- People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)
What are the different parts of Medicare?
Original Medicare is a fee-for-service health plan that has two parts:
Part A (Hospital Insurance) and Part B (Medical Insurance). Medicare Part A (Hospital Insurance) helps cover:
- Inpatient care in a hospital
- Skilled nursing facility care
- Hospice care
- Home health care You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A.
Medicare Part B (Medical Insurance) helps cover:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (DME)
- Many preventive services
Most people pay the standard monthly Part B premium.
Note: Original Medicare pays for much, but not all the cost for health care services and supplies. Medicare Supplement Insurance policies, sold by private companies, can help pay some of the remaining health care costs, like co-payments, coinsurance, and deductibles.
Medicare Supplement Insurance policies are also called Medigap policies.
What are the different parts of Medicare? (continued) Medicare
Part C (Medicare Advantage):
- Includes all benefits and services covered under Part A and Part B
- Usually includes Medicare prescription drug coverage (Part D) as part of the plan
- Run by Medicare-approved private insurance companies that follow rules set by Medicare
- Plans have a yearly limit on your out-of-pocket costs for medical services
- May include extra benefits and services that aren’t covered by Original Medicare, sometimes for an extra cost Medicare Part D (Medicare prescription drug coverage):
- Helps cover the cost of prescription drugs
- Run by Medicare-approved drug plans that follow rules set by Medicare
- May help lower your prescription drug costs and help protect against higher costs in the future Note: If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. For more information on programs that can help pay for your health care costs visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).
TTY users can call 1-877-486 3
Medicaid is a joint federal and state program that helps pay medical costs if you have limited income and/or resources and meet other requirements. People with Medicaid may get coverage for services that Medicare may not or may partially cover, like nursing home care, personal care, and home- and community-based services. Each state has different rules about eligibility and applying for Medicaid. If you qualify for Medicaid in your state, you automatically qualify for Extra Help paying your Medicare prescription drug coverage (Part D).
You may be eligible for Medicaid if you have limited income and are:
- 65 or older
- A child under 19
- Living with a disability
- A parent or adult caring for a child
- An adult without dependent children (in certain states)
- An eligible immigrant in many states, more parents and other adults can get coverage now.
If you were turned down in the past, you can try again and may qualify. When you enroll, you may be able to get health care benefits like:
- Doctor visits
- Hospital stays
- Long-term services and supports
- Preventive care, including immunizations, mammograms, colonoscopies, and other needed care
- Prenatal and maternity care
- Mental health care
- Necessary medications
- Vision and dental care (for children) You should apply for Medicaid if you or someone in your family needs health care.
If you aren’t sure whether you qualify, a qualified caseworker in your state can look at your situation. Contact your local or state Medicaid office to see if you qualify and to apply. To get information about your state’s Medicaid program, visit HealthCare.gov/Medicaid-chip/getting-Medicaid-chip. CMS Product No. 11306 Dual eligibility Some people qualify for both Medicare and Medicaid and are called “dual eligible.” If you have Medicare and full Medicaid coverage, most of your health care costs are likely covered. You can get your Medicare coverage through Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). If you have Medicare and/or full Medicaid, Medicare covers your Part D prescription drugs. Medicaid may still cover some drugs and other care that Medicare doesn’t cover.
For more information on Medicaid, visit HealthCare.gov/Medicaid-chip/gettingmedicaid-chip. If you have questions about Medicare, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. You have the right to get Medicare information in an accessible format, like large print, Braille, or audio. You also have the right to file a complaint if you feel you’ve been discriminated against.
or call 1-800-MEDICARE (1-800-633-4227) for more information.
TTY users can call 1-877-486-2048. Paid for by the Department of Health & Human Services.
This article is written for help & information purposes only, data and source are https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare