What is the difference between Medicare and Medicaid?

What is the difference between Medicare and Medicaid?  And, can people be covered by both Medicare and Medicaid at the same time?

The answer to this is a little tricky.  Let’s begin with the first question, of what is the difference between Medicare and Medicaid.

  • Medicare provides health coverage for Individuals ages 65 +, OR persons under the age of 65 with a disability (regardless of income).  Medicare is FEDERALLY funded.
  • Medicaid provides health coverage for Individuals whose household income is below or near the Federal Poverty Level or individuals who require long term care and support.  Medicaid is FEDERALLY and STATE funded.

Can a person be covered by both Medicare and Medicaid?

Yes.  Some may qualify for both depending on age, disability status, and income levels.  Many people who qualify for both Medicare and Medicaid choose to get a plan called a Dual Special Needs Plan (DSNP).  DSNP’s coordinate care of persons who qualify for both Medicare and Medicaid and simplify how this care is covered.  When it comes to DSNP plans, Medicare pays first and then Medicaid picks up the cost share or may cover additional services that Medicare did not.

DSNP’s manage care in a unique way and many offer enhanced benefits to the individual.  For more information on DSNP’s please contact Lori Good at Beck Insurance Agency in Archbold or Whitehouse, Ohio.  You can call Lori at 419-446-2777, email us at help@beckinsurance.com, or click here to submit your request.

If you think you might qualify for Medicaid, reach out to your local Job and Family Services office for more information.

 

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