Medicare and Medicaid: What Are the Differences Part 1

1
Medicare and Medicaid
What Are the Differences? (Part 1)
2
Medicaid and Medicare are two important
healthcare programs available to citizens of the
United States
3
They were created when the Social Security Act
was amended in 1965 and are managed by the
Centers for Medicare and Medicaid Services
4
These programs effectively extended healthcare
coverage to almost all Americans age 65 or older
5
and healthcare services to low-income children
without parental support and the relatives who
take care of them, the elderly, the blind and
individuals with disabilities
6
Though these programs have similar purposes,
they are very different in terms of how the
programs are run, who can be eligible for
benefits and the limits on those benefits
7
Medicare
8
Medicare is essentially an insurance program
available to
9
Through this program, patients pay a portion of
the costs for medical treatment through
deductibles and monthly premiums are required for
non-hospital coverage
10
Medicare benefits are usually provided by private
companies that contract with Medicare to provide
those benefits
11
Because Medicare is a federal program, it is
basically the same everywhere in the United States
12
Medicare has several different parts that cover
specific kinds of services
13
Medicare Part A
14
Medicare Part A (Hospital Insurance) helps pay
for care in a hospital and skilled nursing
facility, home health care and hospice care
15
Most people don't have to pay for Medicare Part A
because Medicare provides the coverage
16
You have a choice of any doctor, hospital or
other healthcare provider that accepts Medicare
17
You or your supplement insurance coverage would
be responsible for deductibles and coinsurance
(or copays)
18
Medicare Part B
19
Medicare Part B (Medical Insurance), which helps
pay for doctors, outpatient hospital care and
other preventive medical services
20
Most people do pay for Medicare Part B
21
With Part B, you can also choose any doctor,
hospital or other healthcare provider that
accepts Medicare
22
You or your supplement insurance coverage would
be responsible for deductibles and coinsurance
(or copays)
23
Medicare Part C
24
Medicare Part C (Medicare Advantage Plans) are
offered by a private company that contracts with
Medicare to provide Part A and Part B benefits
25
Medicare Advantage Plans include the following
26
Coverage is provided by the private insurance
companies that are APPROVED BY MEDICARE
27
You are required with most plans to use doctors,
hospitals and other providers who are within the
plan
28
You are required to pay monthly premiums in
addition to any Part B premium that you pay,
along with deductibles and copays
29
Medicare Part D
30
Medicare Part D (prescription drug coverage)
adds prescription drug coverage to Medicare
Parts A and B, some Medicare Cost Plans, some
Medicare Private-Fee-for-Service Plans, and
Medicare Medical Savings Account Plans
31
If you want this coverage, you should join a
Medicare Prescription Drug Plan and pay the
monthly premium
32
These plans are run by Medicare-approved
companies
33
Some Medicare Advantage Plans offer prescription
drug coverage
34
If they do not, you can join a Medicare
Prescription Drug Plan
35
What do you do about gaps in your healthcare
coverage?
36
If there are any gaps in your healthcare
coverage, you can obtain what is known as a
Medicare Supplement Insurance or Medigap policy
through a private company
37
However, if you have a Medicare Advantage Plan,
you cannot use a Medigap policy to pay for any
out-of-pocket costs
38
In fact, if you already have a Medicare
Advantage Plan, you cannot be sold a Medigap
policy
39
Who is eligible for Medicare?
40
You are generally eligible for Medicare if
41
If you are not 65, but you have a disability or
End-Stage Renal disease requiring dialysis or a
kidney transplant, you may also qualify
42
Learn More About Medicare in Arkansas
43
Deborah Sexton Law Office
www.arkansas-estateplanning.com
[phone]