What is the difference between Medicare and Medicaid?

Medicare is funded through the federal government and administered by Social Security. Medicaid is offered through the state and funded jointly with the federal government. 

Eligibility

Medicare is for American seniors and those with disabilities. People become eligible when they reach the age of 65. Those with disabilities become eligible after receiving Social Security Disability Insurance for at least 24 months, regardless of age.

Medicaid is based on financial need, helping people below a certain income threshold to access medical care. You can apply for Medicaid if you are low income and have a disability, are blind, or are over 65.

Coverage

Medicare covers hospital and medical insurance. Part A covers inpatient care in a hospital, skilled nursing facility care, nursing home care, hospice care, and home health care. Part B covers medically necessary services and preventive screening services. This includes clinical research, ambulance services, durable medical equipment, mental health care, and limited outpatient prescription drugs.

Medicaid has mandatory and optional benefits, which are up to the jurisdiction of the state. The mandatory benefits are hospital services, physician services, laboratory and x-ray services, and home health services. The optional services are prescription drugs, case management, physical therapy, and occupational therapy. All children have dental service benefits under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Medicaid also covers long-term care, and it is often used for nursing home care.

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