Medicaid vs. Medicare 101

Although Medicaid and Medicare provide essential services for our loved ones and thousands of Americans, many people either do not know the specifics of each program or simply do not know the difference. Well not anymore! Provided below are the basics everyone should know when dealing with these two aid programs and a basic layout of their differing eligibility requirements, coverage, and funding.

Medicare

Medicare is a federally funded and administered program that provides health insurance for individuals older the age of 65, individuals with disabilities, or individuals with End-Stage Renal Disease (ESRD). Its coverage includes: inpatient services from a hospital or nursing facility, outpatient services, doctor visits, and preventive care, prescription drug costs, or a combination of these services. Most seniors are automatically enrolled when they turn 65, yet those that are disabled are required to contact their local Medicaid office if interested in being enrolled, however cost is not distinguished by qualifying factors but rather is the cost depends on the “level of coverage” assessed.

Medicaid

Medicaid is a federal and state program that is administrated by the state government with the purpose of providing coverage for low-income families. Its coverage includes: hospital and nursing care, certified pediatric and nurse practitioner services, access to federally qualified centers, as well as access to rural health clinic or birth centers licensed by the family’s state. All of those who wish to receive Medicaid benefits must apply within their state office in order to become eligible and costs depend on the income of each family.

Can A Person Qualify for Both Medicare and Medicaid in New York?

Individuals may be dually eligible for both programs. In many of these cases, Medicaid will cover Medicare premiums or co payments for the services covered under Medicare. This allows for effective and comprehensive health coverage.

Contact an Attorney

If you believe you qualify for Medicare or Medicaid and wish to receive benefits, or if you have been previously denied coverage, contact an experienced New York Elder Law Attorney. A skilled attorney can analyze your situation, discuss your options with you, and help ensure your legal rights are protected.

Author: Tanya Hobson-Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John's University and her law degree from Benjamin N. Cardozo School of Law. Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly.

One thought on “Medicaid vs. Medicare 101”

  1. Medicaid is a public assistance program based largely on financial need; it s paid for with public funds collected through taxes. Unlike Medicare, a federal program, both state governments and the federal government fund Medicaid. The program, which provides health insurance to low-income Americans of all ages, works differently in each state, although federal guidelines apply.

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