When it comes to senior healthcare insurance, we all want to choose what’s best for us. The technicalities of insurance programs, however, tend to get confusing for many of us.
Many people get confused between plans and have a hard time figuring out if they meet the eligibility criteria or not. Sometimes, it’s also easy to confuse programs like Medicare and Medicaid, since they appear to be identical. However, that couldn’t be far from the truth.
Medicare and Medicaid are both governmental healthcare programs. The difference between them is simple: they cater to different groups of people.
Medicare and Medicaid are maintained and managed by the Centers for Medicare and Medicaid Services under the U.S Department of Health and Human Services.
What is Medicaid?
Medicaid is a social protection program that covers over 73.5 million people across 51 states, as per a 2018 estimate.
The health spending per capita by the U.S government for Medicaid has increased significantly over the last three decades. According to the latest estimates, health spending per capita for Medicaid programs has reached well over $8,000 in some states—$8,233 in 2010.
Who Does It Cater To?
Medicaid is a mean-tested health and medical services program. It caters to families who find it difficult to meet their health expenditure due to a low income and fewer resources. Although the program is enforced at a federal level, each state sets its own eligibility criteria; the amount, scope and duration of the services; the rate of payment for the services and administers its own Medicaid program.
Who Pays for Medicaid Services?
Medicaid does not make payments to individuals. Instead, it makes payments to healthcare providers. The federal government reimburses these payments to the state governments, after which, the states extends small deductibles, coinsurances and copayments toward Medicaid beneficiaries for specific services.
Who Is Exempt from Being A Medicaid Beneficiary?
Medicare beneficiaries don’t include pregnant women, children under 18 years of age and health care providers, including nurses who are likely to contribute their income into institutional healthcare. It further exempts all Medicare beneficiaries from co-payments for emergency and family planning services.
What is Medicare?
Medicare is a Federal health insurance program that makes payments for the healthcare of seniors and Americans with certain disabilities.
There are four parts to the Medicare program. Part A and Part B cover hospital and medical insurance; Part C and D cover prescription drugs and provide the flexibility to customize Medicare plans to closely match their healthcare needs.
Who Does It Cater To?
Medicare beneficiaries meet one of the following three criteria: the individual must be at least 65 years of age; the individual may be under 65 years of age and be differently-able; the individual belongs to any age group but faces an end-stage renal disease such as a permanent kidney failure and needs dialysis or a kidney transplant.
Are All Medicare Services Paid for Through The Plans?
Medicare services are provided for by the Federal government through an allocation of taxes from wages. However, there are services that are not covered by the Medicare program.
Those services are then covered through the MediGap program which consists of 12 plans that are sold and administered by authorized private companies. It must be noted that since the Medicare programs have upgraded to include Part D of the program, MediGap is no longer used to cover prescription drugs.
Who Is Exempted from Being A Medicare Beneficiary?
Medicare plans are only available to individuals, who are U.S. citizens, permanent legal residents for 5 continuous years and are additionally eligible for Social Security benefits with a minimum of ten years’ payments made into the healthcare system.
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If you want to learn more about the Medicare for seniors New Jersey programs and find out about which Medicare supplement plans are for you, get in touch with Seniors for Medicare.
As a licensed insurance agency for Medicare plans in New Jersey and New York, Seniors for Medicare works with their clients to make their health insurance journey easy and hassle-free.
For more details and information, visit their website or reach out at 800-276-1753 to get in touch with a licensed insurance agent.
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