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  • What’s the difference between Medicare and Medicaid?
  • Medicare

What’s the difference between Medicare and Medicaid?

Angie K. Claar June 10, 2022

Cost is always a factor when you start conducting research about senior living communities for yourself or a loved one. Everyone wants to be comfortable in retirement and baby boomers are especially attuned to the market and the rising cost of living.

One consideration to make is if a community accepts Medicare and Medicaid. Not all do. And there is a big difference in these two programs.

Evenglow Senior Living is a Life Plan Community in the heart of Pontiac offering a variety of living environments and arrangements to help meet the growing demand for senior living options.

Evenglow is a not-for-profit and faith-based community with four levels of care: The Residences at Evenglow (independent living), The Lodge at Evenglow (assisted living), The Inn at Evenglow (memory care) and Tjardes Health Center (skilled nursing and rehabilitation) at Evenglow.

To help you with your search for the right senior living community, we’d like to share the difference between Medicare and Medicaid. And some people do qualify for both.

People who are 65 or older or have a disability or medical condition usually qualify for Medicare, a federal program. Medicare Part A and Part B are provided by the federal government, and Medicare Part C and Part D, while federally governed, are provided by private insurance companies.

Medicare Part A is hospital insurance and Part B is medical insurance. Medicare Part D is prescription drug coverage and Part C (Medicare Advantage) is an all-in-one coverage option that combines Parts A, B and D, as well as other benefits that may include items like dental, vision, fitness and hearing. Medicare Part A and Part B coverage is standard, but Part C and Part D varies based in terms of coverage provided depending on the plan, the insurance provider and your location.

On the other hand, Medicaid is a program run by state governments that helps pay health care costs for people with limited income and resources, and different programs exist for specific populations. Medicaid plans vary from state-to-state but follow federal guidelines for benefits.

Both Medicare and Medicaid may include premiums, deductibles, copays and coinsurance. For Medicare, how much you pay will vary based on when you enroll, what coverage options you select and what health services and items you use throughout the year. For Medicaid, the amount you pay depends on your income and the rules in your specific state. Additionally, some specific groups under Medicaid are exempt from many out-of-pocket costs.

There are also different Medicare savings programs which are designed to help with the cost of Medicare. If you meet the conditions to qualify for one of these programs, you could get help paying for your Medicare premiums, and in some cases, also get help paying Medicare Part A and Part B deductibles, coinsurance and copayments.

As previously mentioned, some people can have both Medicare and Medicaid. People who qualify for both Medicare and Medicaid are called “dual eligible.” If you qualify and choose to enroll in both programs, the two can work together to help cover most of your health care costs.

We are here to answer your questions and to assist you in making the best decision for you and your loved ones. Visit https://evenglow.org/ for more information or call 815-844-6131.

Amy Eppel is Marketing and Communications director at Evenglow Senior Living

This article originally appeared on Pontiac Daily Leader: Amy Eppel explains the difference between Medicare and Medicaid

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