Medicare and Medicaid may sound extremely similar on the surface, but there are actually a number of key differences between them that all Memphis residents should know.
Medicare is available to any person 65 years of age or older who has been a United States resident for at least five years. It is also available to individuals with certain disabilities who are under the age of 65.
Medicare is divided into four different parts, each providing a different area of coverage and with a different cost associated.
The first part, or Part A, is called hospital insurance. It pays for overnight hospitalization and the subsequent fees associated with such treatment. It can also cover stays in nursing facilities for up to 100 days, with the first 20 days being paid in full by Medicare while the remaining 80 require a patient co-payment. Part A is provided with no cost to any Memphis or U.S. citizen 65 and older who has worked for 40 or more quarters in his or her lifetime.
The second part of Medicare, also known as Part B, is medical insurance. This optional coverage fills in the gaps left by Part A, and usually pays for work done during routine outpatient visits, including x-rays, blood work, vaccinations, ambulance transportation, etc. It also covers necessary medical equipment related expenses a patient may require, such as prosthetics, canes, and wheelchairs.
The third part, Part D, covers a patient’s prescription drug costs. It is a recent addition to Medicare and is available to anyone who is currently covered by Part A or B. It does not cover any drugs that have not been approved by the FDA, as well as most fertility drugs, weight loss drugs, certain pain medications and drugs designed for cosmetic purposes.
Finally, there is Part C – a customizable and more extensive plan also known as Medicare Advantage. With Medicare Advantage, patients are automatically enrolled in Parts A and B and also have the option to enroll in Part D. It is generally less expensive than the other plans due to a lower monthly premium, but individual co-payments after receiving treatment can be higher than with standard Medicare.
On the flip side of this, there is Medicaid.
Much like Medicare, Medicaid is a government-controlled health insurance program that provides support for patients requiring inpatient or outpatient services. Unlike Medicare, however, Medicaid is funded on the state level. For residents of Memphis and throughout the state of Tennessee, it is commonly known as TennCare.
Instead of eligibility for Medicaid being based strictly on age or disability status like Medicare, it is also dependent on a person’s income, overall assets, and citizenship. States are required to provide Medicaid services to low income individuals below the poverty line, as well as any person receiving federal income assistance. Some people can actually receive benefits from both Medicare and Medicaid at the same time.