Difference between Medicare and Medicaid

 

Medicare

  • What it is: A federal health insurance program, the same in every state.

  • Who qualifies:

    • Adults 65 and older, regardless of income.

    • Younger people with certain disabilities or end-stage renal disease (ESRD).

  • Coverage:

    • Part A – Hospital insurance (inpatient care, skilled nursing, hospice).

    • Part B – Medical insurance (doctor visits, preventive services).

    • Part C (Medicare Advantage) – Private plans that bundle A & B, often with extras like dental/vision.

    • Part D – Prescription drug coverage.

  • Costs: Generally includes premiums, deductibles, and co-pays (though Part A may be premium-free if you paid enough Medicare taxes).


Medicaid (Florida Medicaid)

  • What it is: A joint federal and state program, run by the Florida Department of Children and Families (DCF) and the Agency for Health Care Administration (AHCA).

  • Who qualifies:

    • Low-income individuals and families.

    • Seniors with limited income and assets.

    • Pregnant women, children, and people with disabilities.

    • Nursing home residents or those needing long-term care (through Medicaid Waiver or Institutional Care Program).

  • Coverage:

    • Hospital and doctor visits.

    • Long-term care (nursing homes, assisted living, home care) — something Medicare does not fully cover.

    • Prescription drugs (with limitations).

    • Dental and vision (for children, limited for adults).

  • Costs: Usually free or very low cost, but strict income and asset limits apply. In Florida, seniors may need tools like a Qualified Income Trust (QIT) to qualify.

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