Medicare Vs. Medicaid: Know the Difference

The names sound very much the same. Both are run by the Centers for Medicare & Medicaid Services (CMS) and they currently cover approximately 100 million people, but Medicare and Medicaid are very different. In order for you to make the most of your benefits, it’s important to understand the differences.

According to the U.S. Department of Health & Human Services, here’s what you need to know about Medicare versus Medicaid.

Understanding Medicare

• What it is: Medicare is a federal insurance program.
• Who it’s for: People over the age of 65, regardless of income. Medicare is also for younger disabled people and kidney dialysis patients.
• Who pays for it: It is funded to cover your medical bills from two trust fund accounts paid for mainly by payroll taxes from employees, employers, and the self-employed.
• What you pay: You pay deductibles to cover your part of the costs, and pay low monthly premiums for coverage that is not hospital-related.

Understanding Medicaid

• What it is: Medicaid is an assistance program.
• Who it’s for: Anyone who is designated “low income” and falls into any of the following categories:
  • Adults 65 or older
  • Children under 19 years old
  • Pregnant women
  • Those living with a disability
  • A parent or adult caring for a child
  • An adult without dependent children (in certain states)
  • An eligible immigrant
• Who pays for it: Medicaid is both a federal and state-run program. Each state’s program is different when it comes to eligibility and applying.
• What you pay: Care is basically free, although some people may pay a very small copayment.

Now that you have an understanding of Medicare vs. Medicaid, you can help ensure that you make the best decisions about your healthcare now and in the future.

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A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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