Disability, Medicare

Is it Medicare or Medicaid?

November 16, 2017 • By

Last Updated: November 16, 2017

man and doctor chatting A lot of 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 earned-benefit program for Americans aged 65 or older or disabled. Workers pay into Medicare throughout their working years. 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. You can find out more about Extra Help and file for it at www.socialsecurity.gov/medicare/prescriptionhelp. 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 its 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.


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Jim Borland, Acting Deputy Commissioner for Communications

Comments

  1. Kirk Edwards sr

    How can the government cut money on medicare when working people paid thier money into it all thier working life.

    • Tom

      Because people vote away their rights and earned entitlements, that’s why. There are millions of low-information voters who believe government is their enemy instead of the guarantor of these rights and who believe the poor and destitute are making this whole country poor. So they vote for politicians who reduce the taxes of the rich and well-placed who pay these politicians off while promising more “good-paying” jobs that never show up. Then when deficits are created, the programs they paid their whole life for through their own taxes keep getting reduced. If you think watching Fox News makes you informed, guess again. All it does is make you angry. That is not the same thing as smart.

      • shy

        They make these company and politician stop violating our rights and stop caring about the rich only. Most people vote for politician for what come out their mouth and don’t investigate what they really doing behind closed doors. Money is being uncounted for and nothing is done to the theifs. If we didn’t they would punish us. The people are being neglect in and living in proverty while the very rich down the power or want them to die by taking their insurance. And have them live in unsafe housing that they are getting government funding to keep up and tenant have to suffer senior disable and all. Look at all the up keep and maintenance provision and air heating system and faucets leeks mold and bunch of mess neglected you see it every where on t.v . Now because people getting by with hiding murder.

  2. LILY CONDE

    Sir; do you have information about which company has better price for prescription medication .
    I have United health . Now I have to take Residronate sodium 150 mg and the cost is very high for me.
    Any suggestions. ???

    • Jenn

      Write or call the company. They may help you. If not you can ask your doctor for samples.

  3. Richard Fritz

    Many of our doctors have opted out of Medicare. We have secondary (Gap) insurance but it does no good because they won’t honor any claims until Medicare
    issues their Summary notice. Only providers can submit Medicare claims,so that leaves many of our medical expenses to be “out of pocket”. Why can’t patients submit claims to Medicare. Even if they are disapproved because the doctor doesn’t participate, at least we would have a chance that the secondary insurance might cover some of the costs.

    • Ray Fernandez, Public Affairs Specialist

      Hi Richard. The Medicare program, is managed by the Centers for Medicare & Medicaid Services (CMS). Please visit their website at https://www.cms.gov/ for information. Thanks!

    • Marc

      I submit claims to Medicare myself. If you pay the doctor you just send in the form. Sheesh. Another person bashing the program when they have their facts incorrect.

  4. John

    They should do away with Medicaid because it’s like a reward for not working during your lifetime.

    • Marc

      You mean the Medicaid that pays for the assisted living or nursung home for your elderly parents and/or grandparents who are RETIRED but not able to care for themselves any more but who don’t have $3000/month for private assisted living? THAT’S one of the groups you’re slamming…also disabled people who worked but lost everything due to becoming disabled & now are too poor to afford medical insurance. People who judge are bad enough; those who judge when they don’t even have the facts right are despicable.

      • shy

        I am with you on that.Hope it never happen to them and they cut it off. Sad some people careless about the sick and needy. We all still the same in God eyes. Lord help this world in the name of Jesus I pray.

      • gm walker

        I totally agree with your comments. I lost my job due to health problems and I thank God I had Medicaid to see me through my unemployed, homeless time. So, yea, people should not be judgemental ; they may be in this situation theirself someday.

        • Connie Christenson

          I totally resemble that comment.

    • Steven Bible

      John you are EVIL. these people me help.

      • Steven Bible

        Need help

      • S Biblle

        These people need help

    • Steven Bible

      John you are EVIL. THESE PEOPLE NEED HELP

  5. laura pando

    I decided to keep my husband’s private Medical Program (currently SSS) and pay for it after I qualified for Social Security at age 66 and he had retired from work. I want to know if we decide to get Medicare Part B, can we get it without penalty, this is, without having to pay extra for Medicare B. Could you clarify?

    • Ray Fernandez, Public Affairs Specialist

      Hi Laura. Under certain conditions, you may qualify for a Special Enrollment Period, which would allow you to sign up for Medicare Part B if you are past your Initial Enrollment Period. If you or your husband are actively working and covered under an employer’s group health insurance program, you can delay enrollment into Medicare Part B until the work activity stops or the health coverage is dropped. Also, because you must pay a premium for Part B coverage, you have the option of turning it down.
      If you didn’t sign up for Medicare Part B when you were first eligible, and you aren’t eligible for a Special Enrollment Period, you can sign up during the General Enrollment Period, between January 1 – March 31 each year.
      We suggest that individuals speak to their health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. To learn more about the Medicare enrollment periods got to http://www.Medicare.gov or visit our Medicare web page for more information.
      For specific questions about your case, call 1-800-772-1213 and ask one of our agents to assist you. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Or you can contact your local Social Security office directly. Hope this helps!

  6. Wahabi Shittu

    Are you saying that people had to be retired to apply for medicare?

    • Ray Fernandez, Public Affairs Specialist

      Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. See our Medicare web page for more information.

      • Randy G Chapman

        Dido.

  7. Ann R Fox

    Here’s an easy way to tell the difference: If you have worked most of your life you get Medicare & pay 20% of every expense covered.

    If you didn’t work a day in your life you get Medicaid & that covers 100% of everything.

    Moral of this sad story: Not working pays much more!

    • Marc

      False. Stupid. Irrelevant now, anyway. Both were fitted in the budget bill, BOTH will be ELIMINATED in the tax bill being voted on any day now. Don’t believe me, read the actual bills in pdf at Congress.gov. You’ll be happy to know that no one will have health insurance, whether they “worked a day in their life” or not…

      • Marc

        GUTTED. not “fitted.” Just to be clear…

        • Ray Mosher

          Rather than gut Health Care, Trump and the Republican Party should be forced to live without Health Care!

          • Carole Hession

            The mess you are in now is not the work of Don Trump nor the Republicans. It’s the fine work of Obama and the hiring to run the show by him of Experian, the Credit Bureau maggots with the morals of snakes, who cheat everyone and think NOTHING of it! Ask them when the last time anyone qualifies for Social Security benefits!! Ask anyone how long Experian was fighting with the Federal Trade Commission for stealing from the public charging them wrongly for credit card checking!! I get so sick of all of it and then I hear idiots like those poor people who have no idea what they are talking about!!

          • Lauren

            I’ll vote for that!

    • Marilyn Durham

      That makes no sense!

    • Maria A Ancira

      that’s sucks!!! how is possible that we, working people have to pay more all the time and THOSE that does not work get everything free? THE LAW IS A SHAME!!

  8. Bruce

    I appreciate the explanation. Thanks!

  9. Bryan Miranda

    CONGRESS JIMMY GOMEZ XAVIER BECERRA KAMALA HARRIS WWE INVESTORS STAKEHOLDERS 2327 RIDGEVIEW AVE HOME CARE CENTER CA.GOV 90041 http://WWW.SBA.GOV http://WWW.DOR.CA.GOV EASTERN REGIONAL CENTER P.O. BOX 7916 ALHAMBRA CA 91802 -7916 TELEPHONE 1-626-299-4700 FAX 1-626-281-1163 SIGN BRYANMIRANDA1028@GMAIL.COM

  10. terrance petersen

    medacide

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