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Medicare vs. Medicaid: What's the Difference?

Medicare is a federal health insurance program that pays for a variety of health care expenses. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is run by the Centers for Medicare and Medicaid Services, an agency of the federal government.

The "Parts" of Medicare

The types of Medicare programs are often referred to as Part A, Part B, Part C, and Part D. Here's an outline of what each "Part" is about.

Medicare Part A

Medicare Part A is hospital insurance. Part A covers inpatient hospital care, limited time in a skilled nursing care facility, limited home health care services, and hospice care.

Medicare Part B

Medicare Part B is medical insurance. Part B benefits cover certain non-hospital medical expenses like doctors' office visits, blood tests, Xrays, diabetic screenings and supplies, and outpatient hospital care. A monthly premium is paid for this part of Original Medicare.

Medicare Part C

Medicare Part C, or Medicare Advantage, insurance often includes every type of Medicare coverage in one health plan. It's offered by private insurance companies contracted through CMS to provide a Medicare benefits package as an alternative to Original Medicare. Enrolling into a Medicare Advantage plan is optional, but to obtain this private insurance, one must also have Original Medicare, Part A and Part B.

Medicare Part D

Medicare Part D is optional prescription drug coverage. Medicare Part D is available as a stand-alone prescription drug plan through private insurance companies, and the monthly fee varies among insurers.
For more information regarding Medicare and its components, please go to http://www.medicare.gov.

Medicaid

Medicaid is an assistance program that serves low-income people of every age. Patients usually pay nothing for covered medical expenses, although a small co-payment is sometimes required. Medicaid is a federal-state program, and it varies from state to state. It is run by state and local governments within federal guidelines.

In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.

In the context of seniors, many hear the word Medicaid as it pertains to paying for skilled nursing care. All states have a Nursing Facility Medicaid program that provides general health coverage plus coverage for nursing home services. These services include room and board, nursing care, personal care and therapy services.

Nursing Facility Medicaid may pay for a stay in a nursing home if you:
  • Need a nursing-home level of care or meet nursing home functional eligibility criteria
  • Have income and assets below certain guidelines.


  • Different states have different standards for determining whether you need a nursing home level-of-care.
    For more information on Medicaid, please go to http://www.medicaid.gov

    What It Means for Senior Living and Memory Care

    Medicare and Medicaid help individuals pay for traditional health care and medical treatment, but it does not fund housing or living expenses associated with aging. Medicare and Medicaid do not pay for a home care service to help a senior who lives alone with errands and housekeeping. It also does not fund living in age-restricted buildings or communities, nor assisted living or memory care in a senior living community.

    If a resident of a senior living or memory care community needs medical attention, tests, surgery, rehabilitation or hospice care, then chances are that Medicare will cover all or part of these medical services. The expenses of living in a senior living or memory care community are funded by the individual.

    Educating seniors and their families about Medicare and Medicaid encourages better preparation and quality of life as one ages. Similarly, as Jehovah's Witnesses it is incumbent upon us to care for one another as we age. Legacy Place prides itself in providing dignifying care to the aging.

    We invite you to ask questions about affording care at our facility. We wholeheartedly encourage you to come for a tour.

     

     Our Phone Number: 484.860.3900

     Our Email Address: Information@LegacyPlace.org


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