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Guilherme Mazui

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What is the Difference Between Medicare and Medicaid?

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Medicare and Medicaid are two distinct government-run health insurance programs that serve different groups of people and are funded by different levels of government. Here are the key differences between the two:

Medicare:

  • Federal health insurance program for people aged 65 or older, and some people under 65 with certain disabilities or conditions.
  • Funded by the federal government.
  • Consists of Part A (hospital services) and Part B (medical care), with Part C and D benefits administered by private insurance companies.
  • Costs are determined by the federal government, and coverage is the same across all states.

Medicaid:

  • Joint federal and state program that provides health coverage to some people with limited income and resources.
  • Funded by both state and federal governments.
  • Offers benefits that Medicare doesn't normally cover, like nursing home care and personal care services.
  • Eligibility requirements and benefits vary considerably from state to state.
  • Costs are formulated based on income and eligibility rules, and can include premiums, deductibles, copays, and coinsurance.

It is possible for an individual to be eligible for both Medicare and Medicaid, known as being "dually eligible". In this case, Medicare serves as the primary payer for medical needs, while Medicaid covers costs that Medicare does not.

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  • What is the Difference Between Medicare and Medicaid?
  • Comparative Table: Medicare vs Medicaid

    • Comparative Table: Medicare vs Medicaid

    Here is a table highlighting the key differences between Medicare and Medicaid:

    Feature Medicare Medicaid
    Purpose Federal health insurance for people aged 65 or older, and some people under 65 with certain disabilities or conditions. A joint federal and state program that helps cover medical costs for people with low incomes.
    Administration Run by the Centers for Medicare & Medicaid Services, a federal agency. Each state runs its own program, with general rules set by the federal government.
    Eligibility Based on age or specific disabilities, not income. Based on income, with limits varying by state.
    Coverage Covers hospitalizations, doctors, and medical care, but does not cover prescription drugs, long-term care, or other add-ons unless additional plans are purchased. Provides comprehensive coverage, including prescription drugs, long-term care, and additional services determined by the state, such as dental care for adults.
    Cost-Sharing Requires monthly premiums, deductibles, and coinsurance for some services. Cost-sharing varies by state, but Medicaid is generally cheaper than Medicare.
    Enrollment 64 million people in Medicare. Over 72.5 million people in Medicaid, including children, parents, low-income adults, older adults, and people with disabilities.

    Please note that some people may be eligible for both Medicare and Medicaid, known as being dual-eligible. In this case, both programs work together to provide health coverage and lower costs.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.