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The Differences Between Medicaid and Medicare

When it comes to receiving Social Security Disability (SSD) benefits or insurance, many people may have two similar yet distinct options in the form of Medicare and Medicaid. Despite the widespread use of these government healthcare programs, not many people understand them, or are even aware that they are separate programs at all. Depending on a handful of crucial details, you could be eligible to receive Medicare, Medicaid, both, or neither. The coverage, and what it costs to get that coverage, will also vary from case to case.

To help you request SSD benefits after you may no longer work comfortably or safely due to an injury, illness, or condition, understanding the differences between Medicaid and Medicare can save you time and trouble. If you have questions about SSD you would like answered as soon as possible, you can always contact Disability Action Advocates toll free at 888.421.8705. Our Las Vegas Social Security Disability Attorneys can also provide you with legal representation should you be managing a SSDI case that has run into contention.

The Basics of Medicare

Medicare is a healthcare and disability program that is solely funded through federal means, making it available to the majority of American citizens over the age of 65, so long as they have paid an ample amount into relevant trust funds; this generally means 10 years of payments taken out of paychecks. Anyone younger than 65 may also qualify for Medicare if they require frequent dialysis sessions or have received 2 or more years’ worth of SSD benefits from the Railroad Retirement Board. Patients who receive hospital or medical treatments through Medicare are expected to pay deductibles, and any treatment performed outside of a hospital or approved clinic will require monthly premiums. Additionally, a yearly fee is required for Medicare treatments of any kind.

The Basics of Medicaid

Run and funded through both state and federal governments, Medicaid is geared towards providing medical benefits to families with low incomes or who live in impoverished areas. As a great number of people can qualify for Medicaid, its benefits are often granted on the basis of who needs help the most and the soonest. Even if you meet all restriction requirements, you might be denied Medicaid initially due to overuse of the program in your state.

Medicaid coverage varies state to state but will always include some coverage for:

  • Basic hospital services
  • Initial diagnosis and testing services
  • X-ray and laboratory technician services
  • Family planning services
  • Pediatric care
  • Healthcare out of home

In some instances and if you are dual-eligible, Medicaid can provide a percentage of coverage for what Medicare will not. Due to the fact that Medicaid will usually cover less upfront than Medicare, many beneficiaries do not need to pay monthly premiums or yearly fees. Instead, copay amounts, generally under $25, are surrendered upfront for any medical or pharmaceutical service.

Want to know more? Contact the DAA and set up an initial consultation today.