Medicare vs. Medicaid: Similarities and Differences

Jul 6, 2018

With such similar sounding names, many people mistake Medicare and Medicaid programs for one another, or presume the programs are as similar as their names. While both are government-run programs, there are many important differences. Medicare provides senior citizens, the disabled and the blind with medical benefits. Medicaid, on the other hand, provides healthcare benefits for those with little to no income.

Overview of Medicare:

Medicare is a public health insurance program for Americans who are 65 or older. Medicare is regulated under federal law and applied uniformly throughout the United States. Medicare pays for hospital care and medically necessary treatments and services but does not pay for long-term care. Medicare can cover payments for certain rehabilitation treatments. For example, if a Medicare patient is admitted to a hospital for at least three days and is subsequently admitted to a skilled nursing facility, Medicare may cover some of those payments. However, Medicare payments for such care and treatment will cease after 100 days.

Overview of Medicaid:

Medicaid is a state-run program, funded by both the federal and state governments. Because Medicaid is administered by the state, the requirements, procedures, and even the name, vary across state lines and you must look to the law in your area for specific eligibility rules. The federal government issues Medicaid guidelines, but each state gets to determine how the guidelines will be implemented. Medicaid is a health care program based on financial need and will cover long-term care. To qualify for Medicaid you must meet strict requirements that demonstrate a financial need – this includes considering assets of both spouses and a 60 month lookback period to scrutinize any unauthorized transfers of assets.

While Medicare and Medicaid do have some similarities, there are many differences. And as Medicaid is a state specific program it is important to talk to an elder law attorney in your state to understand the specific requirements for eligibility in your state.