Medicare and Medicaid
When you reach retirement age, one of the first things on your mind might be whether or not you qualify for Medicare. And if you’re a senior living in a state that has expanded Medicaid, chances are you’ve also been wondering whether or not you qualify for both programs. Here’s an overview of each program and what you need to know to qualify.
What is Medicare?
Medicare is a government-sponsored health insurance program in the United States for people over 65, specifically disabled individuals. You qualify for Medicare if you have paid Medicare premiums for at least five years or have earned income below $85,000 a year.
What is Medicaid?
Medicaid is a government-run health insurance program for low-income Americans. You qualify for Medicaid if you earn less than 138% of the poverty line (about $16,643 for an individual in 2017).
Medicaid provides medical assistance to low-income Americans. Generally, individuals must meet specific eligibility requirements, including being a U.S. citizen or legal resident, having a qualifying disability, and being financially eligible.
Medicare vs. Medicaid
Medicare offers coverage for basic medical needs like doctor visits, hospital stays, and prescription drugs or some plans might cover a caregiver. You don’t have to pay anything out-of-pocket for Medicare.
On the other hand, Medicaid is a federally funded program that provides health insurance coverage to low-income people and those with disabilities. You may have to pay some of your medical bills using Medicaid, but the government will help cover the rest.
If Medicare or Medicaid does not currently cover you, you may be able to qualify for one of these programs if you meet specific requirements:
- You must be a U.S. citizen or resident alien.
- You must have a valid social security number.
- Your income must be below a certain level.
- You must have the ability to prove that you can’t afford to pay for your health care.
There are also some exceptional circumstances under which you may be eligible for both Medicare and Medicaid. For example, if you are pregnant or have a child under 18 years old who is disabled, you may be eligible for both programs.
Both programs have different benefits and eligibility requirements. For example:
- You may be eligible for Medicare if you have permanent physical disabilities or have received Social Security Disability Insurance benefits for at least 12 months.
- You are eligible for Medicaid if you are a low-income person (with income below 138% of the federal poverty level), have children under 18 living with you, or are pregnant.
Both programs provide coverage for various health care services, including medical expenses, hospitalizations, prescription drugs, and mental health services. Finally, it’s important to note that while Medicare and Medicaid are government-run programs, they have different funding levels and approval processes. So it’s essential to check the specific eligibility requirements.
Eligibility for both Medicare and Medicaid
Both Medicare and Medicaid are government-sponsored health insurance programs that provide coverage for the elderly, the disabled, and low-income individuals.
If you are above 65 years or older, you are automatically eligible for Medicare. You must have paid into the system for at least ten years and meet other basic eligibility requirements.
If you are 18 or older and have a disability, you may be eligible for Medicaid. You must be a citizen or legal resident of the United States, be financially needy, and have a physical or mental impairment that considerably limits one or more major life activities.
There are some exceptions to these general rules. For example, you may be ineligible if you have been convicted of a felony or receive public assistance (such as welfare).
To find out if you qualify for both Medicare and Medicaid, contact your state Social Security Administration office or visit the websites for Medicare or Medicaid.
How to apply for both Medicare and Medicaid
To apply for both programs, you must first file a claim with each program.
Once you have filed a claim with each program, they will work together to determine your eligibility. You will need proof of each program’s income and Social Security number.
You must decide which one you want to use if you are eligible for both programs. Both programs have different benefits and requirements, so it is essential to research each option before deciding.
What to do if you’re rejected for Medicare or Medicaid
If you’re 65 or older, you may consider whether you qualify for Medicare or Medicaid. If you’re unsure, read on to find out how to qualify.
To qualify for Medicare, you must be a U.S. citizen or qualified alien who has been resident in the United States for at least five years and is not blind or disabled.
You must also have paid into the Social Security system for at least ten years and have a low income (less than $34,000 for a single person, $44,000 for a married couple filing jointly).