Comparing and Contrasting Medicare and Medicaid

Over the last several years, there has been a lot of debate over various health care programs, with Medicare and Medicaid being some of the most recognizable names in the discussion. Medicare and Medicaid are often incorrectly treated as interchangeable groups, in no small part because of how similar their names are. While the programs may sound like they belong together, they are actually two completely different programs. In fact, Medicare is actually made up of four different parts. Another big difference between the programs is that Medicare is a federally funded program. In comparison, Medicaid is both a federal and state program. This may seem like a minor difference, but it directly impacts how the programs are run. Since Medicaid is a state and federal program, states are given an expanded role in how they implement the program, which is why some states have an expanded version of Medicaid, while others have the traditional version. Additionally, in terms of what services are provided, Medicare and Medicaid serve completely different purposes.

Medicaid in Ohio

When comparing the two health care programs, it makes the most sense to first look at Medicaid. Medicaid offers more extensive coverage, and because it is under one general package, it is easier to understand when compared to Medicare. The Ohio Medicaid program offers health coverage for several demographics that would otherwise be unable to receive this coverage. These groups include low-income residents, pregnant women, infants and children, older adults and also any residents who receive disability benefits. Since Ohio uses the expanded Medicaid plan, the income eligibility requirements are not as strict as with the traditional plan.

In order to receive Medicaid in Ohio, the applicant must be a legal Ohio resident, have a Social Security number, and he or she must meet all of the financial eligibility requirements. Applicants that meet all of these requirements will receive a Medicaid managed care plan, which covers a number of different medical expenses.

Some of the categories that Ohio Medicaid covers include dental care, emergency costs, family planning, general health checks, hospital visits, medical equipment costs, mental health services, vision care and many other services. While this is very extensive coverage, it is important to note that some of the services have limitations, such as only covering costs up to a certain extent or setting a maximum number of visits for beneficiaries each year.

Medicare Coverage in Ohio

Medicare is a health care coverage program that is available primarily to Ohio residents that are at least 65 years old, or residents with disabilities. Applicants must either be U.S. citizens or have been legal permanent residents for at least five years. There are four different parts of Medicare available in Ohio: parts A through D. Applicants are not limited to just one plan. In fact, some of the plans act as additions to the other plans.

Potential beneficiaries will receive a welcome packet in the mail several months before they turn 65. The packet will contain specific instructions about how to apply, as well as what plans the resident may already be eligible for. In many situations, residents are automatically enrolled into Medicare Part A. This is the most common plan because it is available for free to applicants who are eligible for Social Security. In addition, any applicants who receive railroad retirement benefits in the state of Ohio are also automatically eligible for Medicare Part A coverage.

Part A coverage consists primarily of inpatient hospital care. This includes nursing home care, hospice and other types of home health services as well. Medicare Part B covers more general medical services. Some of the services covered by Part B include doctor visits, preventive healthcare services, ambulance services, mental health services, some costs for medical equipment and also limited prescription drug coverage.

In most situations, beneficiaries are recommended to enroll in both Part A and Part B, since this offers the most extensive health care coverage in Ohio. Medicare Part C is an optional part of the program. It is sometimes known as a Medicare Advantage Plan. Part C is essentially a customized plan offered through a private insurance provider as opposed to a federal plan. Depending on the provider, beneficiaries may end up paying less in premiums or copayments. In addition, some providers offer some additional benefits, such as dental or vision.

Medicare Part D focuses solely on prescription drug costs and is highly recommended for any beneficiaries who make frequent visits to the pharmacy. All of the different Medicare programs are compatible with Medicaid, so beneficiaries are able to enjoy the benefits of both health care programs if they meet the eligibility requirements.