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Medicare is a federal program that provides health coverage for those who are 65 and over or irrespective of income and even under 65 if they have a disability. Medicaid, on the other hand, is a state and federal health coverage program for those with very low incomes. Together they hope to provide affordable health care for those who need it most.
While you have a number of coverage options, understanding the differences can save you money in the long run.
Key Differences
Medicare…
- An age-based program for those who are 65 years and older. Exceptions to the age rule are people with specific medical disabilities or diseases.
- It is meant for individuals.
- Might be subject to a penalty if you apply for it outside the open enrollment period.
- The basics are standard throughout the country.
- Plans A and B do not include dental care like tooth extractions, dentures, cleanings, fillings, dental plates, or other dental devices. Under certain special circumstances, Part A might cover dental care in a hospital.
- May include only a basic vision test under Medicare Part B coverage. This is usually covered in the preventive initial visit or the annual visit to ascertain ‘wellness’.
Medicaid …
- An income-based welfare program for those with limited financial resources, regardless of age.
- Takes into account income, household size, disability, and family status before allowing you to qualify.
- Meant to provide low cost and sometimes free health care for individuals or families with limited financial resources, pregnant women, seniors, and people with disabilities.
- It has no enrollment period so you can apply for Medicaid anytime. Mostly, people qualifying for Medicaid are exempt from the individual penalty.
- Coverage and eligibility vary from state to state due to the fact that it’s managed both federally and by the state.
- Offers a basic or mandatory list of benefits that include clinic treatment or hospitalization, doctor services, medical/surgical/dental services, and laboratory/x-ray services. Besides these, the plan also extends to covers family planning and services offered by midwives and more.
- May cover adult preventative dental care and some treatments in other states.
- May cover vision care like optometry care, eye exams, or glasses in most states.