What Are the Differences? (Part 1) Medicare and Medicaid What Are the Differences? (Part 1)

Medicaid and Medicare are two important healthcare programs available to citizens of the United States

They were created when the Social Security Act was amended in 1965 and are managed by the Centers for Medicare and Medicaid Services

These programs effectively extended healthcare coverage to almost all Americans age 65 or older

and healthcare services to low-income children without parental support and the relatives who take care of them, the elderly, the blind and individuals with disabilities

Though these programs have similar purposes, they are very different in terms of how the programs are run, who can be eligible for benefits and the limits on those benefits

Medicare

Medicare is essentially an insurance program available to people over the age of 65 regardless of income level younger people who are disabled patients with End-Stage Renal Disease requiring dialysis

Through this program, patients pay a portion of the costs for medical treatment through deductibles and monthly premiums are required for non-hospital coverage

Medicare benefits are usually provided by private companies that contract with Medicare to provide those benefits

Because Medicare is a federal program, it is basically the same everywhere in the United States

Medicare has several different parts that cover specific kinds of services: Medicare Part A - Hospital Insurance Medicare Part B - Medical Insurance Medicare Part C - Medicare Advantage Plans Medicare Part D – Prescription Drug Coverage

Medicare Part A

Medicare Part A (Hospital Insurance) helps pay for care in a hospital and skilled nursing facility, home health care and hospice care

Most people don't have to pay for Medicare Part A because Medicare provides the coverage

You have a choice of any doctor, hospital or other healthcare provider that accepts Medicare

You or your supplement insurance coverage would be responsible for deductibles and coinsurance (or copays)

Medicare Part B

Medicare Part B (Medical Insurance), which helps pay for doctors, outpatient hospital care and other preventive medical services

Most people do pay for Medicare Part B

With Part B, you can also choose any doctor, hospital or other healthcare provider that accepts Medicare

You or your supplement insurance coverage would be responsible for deductibles and coinsurance (or copays)

Medicare Part C

(Medicare Advantage Plans) Medicare Part C (Medicare Advantage Plans) are offered by a private company that contracts with Medicare to provide Part A and Part B benefits

Medicare Advantage Plans include the following: Health Maintenance Organizations Preferred Provider Organizations Private Fee-for-Service Plans Special Needs Plans, and Medicare Medical Savings Account Plans

Coverage is provided by the private insurance companies that are APPROVED BY MEDICARE

You are required with most plans to use doctors, hospitals and other providers who are within the plan

You are required to pay monthly premiums in addition to any Part B premium that you pay, along with deductibles and copays

Medicare Part D

(prescription drug coverage) adds prescription drug coverage to Medicare Part D (prescription drug coverage) adds prescription drug coverage to Medicare Parts A and B, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans

If you want this coverage, you should join a Medicare Prescription Drug Plan and pay the monthly premium

Medicare-approved companies These plans are run by Medicare-approved companies

Some Medicare Advantage Plans offer prescription drug coverage

If they do not, you can join a Medicare Prescription Drug Plan

What do you do about gaps in your healthcare coverage?

If there are any gaps in your healthcare coverage, you can obtain what is known as a Medicare Supplement Insurance or “Medigap” policy through a private company

Medicare Advantage Plan, you cannot use a Medigap policy However, if you have a Medicare Advantage Plan, you cannot use a Medigap policy to pay for any out-of-pocket costs

In fact, if you already have a Medicare Advantage Plan, you cannot be sold a Medigap policy

Who is eligible for Medicare?

You are generally eligible for Medicare if you are 65 years or older a U.S. citizen or permanent resident of the U.S. you or your spouse have worked for at least 10 years at Medicare-covered job

If you are not 65, but you have a disability or End-Stage Renal disease requiring dialysis or a kidney transplant, you may also qualify

Learn More About Medicare in Arkansas

Deborah Sexton Law Office www.arkansas-estateplanning.com (479) 443-0062