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medicare vs medicaid

Medicare vs. Medicaid: What’s the Difference?

Medicare and Medicaid are commonly mistaken mainly because they sound so similar. Medicare is a federal health insurance program for people over 65 years old, while Medicaid is a federal-state medical assistance program. Here is the best way to remember them:

Medicare – provides coverage for individuals over 65.

Medicaid – provides financial assistance. 

What is Medicare?

Medicare is a health insurance program that provides medical care to people over 65. People of 65 are covered, regardless of their income, but it’s not free. Policyholders pay part of the costs through deductibles for hospital stays, and they are required to pay monthly premiums for health care services. Because the federal government runs Medicare, its coverage, rules, and regulations are the same everywhere in the United States. The program is run by the Centers for Medicare & Medicaid Services.

There are several parts to Medicare:

  • Part A covers hospital bills
  • Part B covers medical insurance
  • Part C is health maintenance organization HMO/PPO
  • Part D covers prescriptions. 

Some of these are options that require the Medicare recipient to pay additional premiums.

What is Medicaid?

Medicaid is a federal and/or state financial assistance program for low-income individuals. Medicaid can either offer you a subsidy towards your health insurance premiums or provide you with free health insurance. Eligibility is based on a person’s income and family size but varies widely depending on what state you live in and covers individuals of every age. Patients sometimes don’t pay any costs for covered medical expenses, but a co-pay is required in other instances. The only way to find out is to contact your state Medicaid office. In New Jersey this program is run by the Get Covered NJ. 

Dual Eligibility: Having Medicare and Medicaid

Some people have both Medicare and Medicaid. Medicaid may cover services that Medicare can’t, like extended long-term care. It may also pay for Medicare’s out-of-pocket costs. Specific programs exist that people with Medicare may be eligible for.

Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.