Many people have a difficult time understanding the difference between Medicare and Medicaid. Both programs begin with the letter “M.†They’re both health insurance programs run by the government. People often ask questions about what Medicare and Medicaid are, what services they cover, and who administers the programs.
Let’s start with Medicare. Medicare is the national healthcare program for those aged 65 or older and the disabled. You pay for some Medicare expenses by paying the Medicare tax while you work. The Centers for Medicare & Medicaid Services is the agency in charge of both Medicare and Medicaid, but you sign up for Medicare A (Hospital) and Medicare B (Medical) through Social Security.
You can apply for Medicare online from the convenience of your home at the link on our website: www.socialsecurity.gov/medicare/. If you’re already receiving Social Security retirement benefits when you reach age 65 or are in the 25th month of receiving disability checks, we will enroll you automatically.
Medicare Part C (Medicare Advantage) and Part D (Prescription Drug) plans are available for purchase in the insurance marketplace. Social Security administers a program called Extra Help to help people with low income and low resources pay for premiums, co-pays, and co-insurance costs for Part D plans. Each year, The Centers for Medicare & Medicaid Services publishes Medicare and You available online at their website at www.medicare.gov/medicare-and-you/medicare-and-you.html. This publication is a user’s manual for Medicare.
Each state runs their own Medicaid program under guidance from the Centers for Medicare & Medicaid Services. Medicaid offers care for the most vulnerable among us. While it does not require paying taxes while working, it does have guidelines about how much income and resources you can have to qualify. Medicaid provides coverage for older people, people with disabilities, and some families with children. Each state has its own eligibility rules and decides which services to cover. The names of the Medicaid program may vary from state to state. You can read about each state’s Medicaid program at www.medicaid.gov/medicaid/by-state/by-state.html. You can find each state’s Medicaid contact information at www.medicaid.gov/about-us/contact-us/contact-state-page.html.
Medicare and Medicaid are two of the major insurance programs that provide healthcare to the American public. Understanding each program, as well as how the two programs differ, can help you and those you care about find the right healthcare program.
Kirk Larson, who wrote this article, is a public affairs specialist in Washington for Social Security.