Here are some of the main differences between Medicare and Medicaid.
Generally, Medicare is a health insurance for senior citizens. It is a health plan offered by the Federal government when a person turns age 65 and has paid Medicare taxes. Medicare is not offered based on income level, like Medicaid. If you are turning 65, you can start applying for Medicare three months before your 65th birthday. Medicare provides free hospitalization coverage through Part A and outpatient services (e.g. doctor’s office visits, physical therapy etc.) through Part B by paying the standard premium of $135 per month. Medicare, unlike Medicaid, does not cover cost of prescription medications however you can purchase prescription coverage by signing up for Medicare Part D. Medicare Part D is provided through private insurance companies and you can select a program that fits your needs via Medicare.gov.
A sure way to distinguish whether you have Medicare or Medicaid is to look at your card. The Original Medicare card has the Red and Blue stripes on top of the card with Part A and Part B written on the front of the card and the Medicaid card has the word “Benefit” written on the front.
Unlike Medicare, Medicaid is a health plan offered by the government generally to those with low to moderate income. Medicaid is funded partly by the Federal government and partly by each State and its local government. Each state has different Medicaid rules. Generally, in New York, your monthly income must be less than $842 as a single individual to be eligible for Medicaid. Unlike Medicare, once you are determined eligible for Medicaid, Medicaid provides free hospitalizations, outpatient services, and prescription medications and even long-term care services.
Medicaid eligibility rules are complex and the guidelines differ depending on your age, income level and the type of Medicaid you need. For instance, if you need Medicaid for long-term care, such as nursing home care, you need to show not only that you have less than $842 in income but also that you do not have more than $15,150 in assets. Medicaid will look back over a five year period to make sure you did not transfer any large assets in order to become eligible for Medicaid. If large asset transfers were made within the last five years, you will not be eligible for Nursing Home Medicaid.
One of the areas of practice at Grimaldi and Yeung, LLP is helping our clients maneuver this complex Medicaid system and make appropriate plans. Contact us at 718-238-6960 to set up an initial consultation with one of our attorneys.