Medicare … or is it Medicaid? This question is frequently asked however, Medicare and Medicaid are different and distinct programs.

The primary difference between Medicare and Medicaid is in eligibility.

Medicaid:

  • Is a joint federal and state funded program specifically designed to help cover medical costs for people with limited incomes and financial resources.
  • The program covers a wide variety of people including: people over the age of 65; people with permanent disability; pregnant woman, child or a parent/caretaker of a child; the blind.
  • Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services.
  • Each state administers its own Medicaid program and has its own Medicaid guidelines.
  • A good way to remember Medicaid is “MedicAID”…. AID to people in financial need.
  • For more detailed information about Colorado Medicaid: https://www.colorado.gov/pacific/hcpf/colorado-medicaid

Medicare:

  • Medicare is a federal health insurance covering anyone with a qualifying work history, who is 65 or older, as well as certain younger people with specific disabilities or end-stage renal disease. Your income and financial assets are irrelevant for qualifying for Medicare.
  • A person can sign up for Original Medicare or an Advantage Plan.
  • Original Medicare is administered directly through the Federal government whereas an Advantage Plan is administered via an insurance company that contracts with Medicare. An Advantage Plan must provide all benefits offered by Original Medicare, but they may also offer more services at a lesser price.
  • A Medicare enrollee can switch coverage annually between October 15 through December 7. So make sure you review your coverage each year to determine if it meets your needs.
  • For more detailed information about Medicare: https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf

Dual Eligible:

  • Finally, there are people who qualify to receive both Medicaid and Medicare and that is referred to as being “Dual Eligible”. Medicaid helps to reduce a person’s overall healthcare cost if they qualify. A little over 100,000 people in Colorado are classified for some form of dual eligibility.

Article written by Gail M. Meehan

Gail M. Meehan MPH, LNHA, CSA
Principal, AgeWise Advisors, LLC,
Founder and Chair, Senior Health Advocates Colorado
Colorado Senior Lobby Board Member
Website: http://www.agewiseadvisors.com/
Phone: 347-852-0752