What is Medicare and Medicaid?
Among government-funded health insurance programs, two to consider for Medicare beneficiaries are Medicare and Medicaid. But what exactly are they, and how do they differ?
According to the Department of Health and Human Services, Medicare is health insurance for people 65 years of age or older, certain people under 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD).1 This federal government program has several parts, with the most frequently referenced parts being that of Original Medicare, Part A (inpatient/hospital coverage) and Part B (outpatient/medical coverage).2
Like Medicare, Medicaid is a government program designed to help people pay for their medical costs. The primary difference in qualification being that Medicaid is designed to help pay medical costs for income restricted patients rather than provide coverage for a certain age group, disability, or ESRD.3 Each state has different rules about Medicaid eligibility, unlike Medicare – which is standardized. As such, income qualifications for Medicaid will vary by state.3
What is Medicare Supplement Insurance?
Medicare Supplement Insurance (also known as Medigap), is designed to help work only with Original Medicare.4 Medicare Supplement Insurance, unlike Medicare and Medicaid, is sold by private insurance companies, and helps pay for some of the remaining health care costs Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.4
The main reason people consider a Medicare Supplement Insurance policy comes down to the fact that one’s Original Medicare policy may not cover all health care costs.4 When facing deductibles and coinsurance in Original Medicare, Medicare Supplement Insurance plans can help Medicare beneficiaries cover costs where it’s needed most. Because there are a number of Medicare Supplement Insurance policies available to consumers on Original Medicare, it may be easier to find your metaphorical ‘glass slipper’ when it comes to getting additional coverage – turning your health care experience from a possible nightmare into a Cinderella story.
Do You Need Medicare Supplement Insurance if You Qualify for Medicare and Medicaid?
The short answer is no. If you have dual eligibility for Medicare and full Medicaid coverage, most of your health costs are likely covered.3 As a result, having a Medicare Supplement Insurance plan wouldn’t necessarily be beneficial to you, in fact, an insurance company is not allowed to issue a Medicare Supplement insurance policy to a Medicare beneficiary who receives full Medicaid health coverage! The purpose of Medicare Supplement Insurance is to cover the cost left by deductibles and coinsurance in Original Medicare, but as full Medicaid coverage should cover the majority of those costs, a Medicare Supplement Insurance policy isn’t necessary.3
Find What’s Right for You
A number of factors influence your coverage eligibility and decisions. As such, it’s important to review your existing coverage before making a decision to enroll in any additional coverage options. Having a comprehensive understanding of what your coverage is and what you may need more of will help you make the best decision possible for your unique situation.
Your style is your choice. Shouldn't your doctor and your coverage be, too?
Coverage of your choice with doctors of your choice are included with plans that don't restrict you to networks of specialists.
1 Medicare.gov, What’s Medicare, 2020
2 Medicareinteractive.org, Introduction to Medicare, 2020
3 Medicare.gov, Medicaid, 2020
4 Medicare.gov, What’s Medicare Supplement Insurance (Medigap)?, 2020
The purpose of this communication is the solicitation of insurance. United American Insurance Company is not connected with, endorsed by, or sponsored by the U.S. government, federal Medicare program, Social Security Administration, or the Department of Health and Human Services. Policies and benefits may vary by state and have some limitations and exclusions. Individual Medicare Supplement insurance policy forms MSA10, MSB10, MSC10, MSD10, MSF10, MSHDF10, MSG10, MSHDG, MSK06R, MSL06R, MSN10 and in WI, MC4810 and MC4810HD, MC4810HDG are available from our Company where state-approved. Some states require these plans be available to persons under age 65 eligible for Medicare due to disability or End Stage Renal disease (ESRD). You may be contacted by an agent or producer representing United American Insurance Company, PO Box 8080, McKinney, TX 75070-8080. OUTLINE OF COVERAGE PROVIDED UPON REQUEST.
For Ohio, you may verify the agent/broker and United American Insurance Company by contacting: The Ohio Department of Insurance 50 W. Town Street, Third Floor - Suite 300, Columbus, OH 43215. Consumer Hotline: 1-800-686-1526 or TDD Number: (614) 644-3745. For costs and complete details of coverage call or write your insurance agent or the company (whichever is applicable).