VA Health Care and Medicare

There are always a lot of questions about Medicare v. Medicaid.   It even gets more complicated when a Medicare v. Medicaid clients from one state to another.   Read on to learn more about these programs and the important differences!  If you recently moved to Florida and have medicare and medicaid, it is important to talk to a local representative that understands the two.   At VHP we have brokers that can help. 

Medicare v. Medicaid

While they sound similar, Medicare v. Medicaid are two very different programs. Both can help you pay for health care and medical expenses but qualifications are difference. Medicare is an age-based federal health insurance program. It guarantees coverage for individuals ages 65 and over and some younger people with disabilities. Although also health care related, Medicaid is a public assistance program for Americans in need of all ages. It is based on income requirements and not age requirements. Read to to learn more about Medicare v. Medicaid​.

Medicare v. Medicaid

Medicare

Medicare is a health insurance policy offered to the senior-citizen in the United States.  Some Americans with Disabilities who are under 65 may also qualify, which sometimes causes confusion. Medicare is considered an entitlement: If you paid Medicare taxes on your earnings while working (they’re usually taken out of your paycheck automatically, just like Social Security contributions), you are automatically eligible for Medicare at age 65. Medicare itself is not income based, which makes it very different than Medicaid.  When discussing Medicare v. Medicaid this is the main way to tell the two programs apart.

 

Medicare comes in four parts. Keep in mond some of the  parts do in fact require payment of a monthly premium similar to private health insurance.  Again, it is important to remember this program is not based on financial need:

 
  • Part A covers hospital care: Covers the cost of being in a medical facility due to an injury or illness.
  • Part B covers doctors, medical tests, and procedures: There is a premium for Part B coverage.  This part covers any procedures done to you.
  • Part C Medicare Advantage: This is an alternative to traditional Medicare coverage. Coverage often includes Parts A, B, and D. Private insurance companies administer Medicare Advantage plans.
  • Part D Prescription drug coverage: Part D is administered by private insurance companies, and you are required to have it unless you have coverage from another source. Part D generally requires you to pay a monthly premium as well.

Medicaid

Unlike Medicare, Medicaid is a public assistance program based on financial need.  This program is  paid for with public funds collected through taxes citizens pay each year. The Medicare program is funded by only the Federal government and the taxes it raises.  Medicaid is funded both in part by the Federal government, but also by individual State Governments as well. The Medicaid program provides health insurance to low-income Americans of all ages.  This program does work differently in each state, although there are federal guidelines apply that states must adhere to as well.

If there is a strong financial need and you fall into one of the following groups, you would likely qualify for Medicaid:

 
  • Aged, blind, or disabled: Medicare comes with sometimes-sizable premium payments. If you are over 65 and can’t afford healthcare coverage, apply for Medicaid, as well. People with medical need may apply regardless of age.
  • You are pregnant: Regardless of you marital status, if you are pregnant and meet income requirements, you and your child will be covered by Medicaid.  It is important to note that if you are married, your spouse would not be covered for any reason.
  • If you have a child under 18, or are under 21 living alone: If you have a child under 18 and you have financial need, you can apply for Medicaid. Also, if your child is sick and needs skilled nursing you may qualify. This may also apply if your child can stay home with quality medical care. Medicaid also covers teenagers living on their own. Depending on the state you live in, they may allow for coverage for “children” up to 21 years old.
  • No disabilities, no children under 18: The Affordable Care Act gave the states an opportunity to provide Medicaid to low-income individuals under the age of 65 without a disability or minor children. This does vary a lot by state, so it is important to check before you apply if you have a financial need.  You can see whether your state is expanding its Medicaid coverage here.

Medicare v. Medicaid: Special Considerations

Medicare v. Medicaid

There are a lot of special considerations for both Medicare and Medicaid.  Often times special circumstances may allow someone to qualify for a program and they may not be aware.  The best way to learn about special considerations is to work with a qualified professional, like the agents of Verus Health Partners.  Because we constantly stay infomred on the ever changing landscape of healthcare, we can help you make the right choices for coverage.  We also can help you understand if there are special considerations that may apply for coverage.

Verus Health Partners Can Help

At Verus Health Partners, we advocate for all of our clients.  Our goal is to ensure you have the proper coverage for your situation.  Contact us today to learn more about Medicare v. Medicaid and what you qualify for.  We will help you determine the right combination for you based on your specific needs.  You can follow us on Facebook for other helpful information.