It is not uncommon to be confused about the difference between Medicare and Medicaid. Although these two programs have similar sounding names, and are administered by the same federal agency, these programs are very different. One major difference between Medicare and Medicaid is that Medicare does not have a financial eligibility test; individuals who are disabled or reach retirement age, qualify for Medicare based on work history. In contrast, all Medicaid recipients must be financially eligible. Another key difference between these programs is the scope of benefits offered. Generally, Medicare does not pay for long term care services, such as nursing home care requiring assistance with activities of daily living. The table below provides an at-a-glance comparison of Medicare and Medicaid.
|
Medicaid |
Medicare | |
| Program: | Health Care | Health Insurance |
| Administered by: | States with federal oversight | Federal |
| Eligibility: | Must Qualify | Entitlement – if paid into the system |
| Qualifications: | Financial & Disability | Age or Disability |
| Covers: | Hospitalization;Doctor Visits;Outpatient Testing;
Skilled Nursing Care; Long Term Care including Custodial Care; Several In-Home Care Programs including Custodial Care; Psychiatric services including case management; Prescriptions |
Hospitalization;Doctors Visits;Outpatient Testing;
Skilled Nursing Care – 100 days maximum per spell of illness; Home Care with Skilled Care Need; Psychiatric Services (no case management); Prescriptions |
| Contribution: | Reimbursement may be required | Premiums and co-pay |
| Estate Recovery: |
Yes (with certain exceptions) |
No |
