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Medicare & Medicaid Guidelines

Both Medicare and Medicaid are government programs that provide health care to individuals who qualify. While Medicare is designed for the elderly and the disabled, Medicaid is available for people of all ages who have low incomes. Medicaid is a state-administered program. Both provide significant benefits for those enrolled.

  1. Medicare Eligibility

    • To qualify for Medicare you must be at least 65 years of age or disabled. Additionally, if you're 65, you or your spouse must have worked for an employer that was covered by Medicare for at least 10 years. You must also be a United States citizen. To receive benefits as a disabled person, you must have a disability that is on a specific list of conditions. For example, if you are blind, deaf or have end-stage renal failure, you could be eligible.

    Medicaid Eligibility

    • Medicaid eligibility is not only dependent on age and whether you work long enough to receive benefits, the program is designed for those who have a significant financial need or have some type of serious medical or physical condition. For example, if you have a low income, have children or are pregnant, you could qualify for Medicaid. If you are blind or have some other type of disability, you may also qualify. Having a low income is not the only criteria for acceptance. The government also looks at your assets, liabilities and expenses when determining if you are eligible.

    Medicare Parts

    • Medicare has three separate categories, each with its own benefits. Once you become eligible for Medicare, you are automatically enrolled in Medicare Part A. This provides you with basic hospital coverage and pays for 80 percent of covered costs. You can also choose to enroll in Medicare Part B and pay a small monthly premium. This option provides you with doctor coverage. Last, you can choose Part C, which combines Parts A and B and is provided by a private company.

    Enrollment

    • You'll receive a Medicare card in the mail three months before your 65th birthday. If you do not want Part B, follow the instructions on the back of the card. Show your card every time you go to the doctor or undergo a medical procedure.

    Payments

    • If you have a covered medical treatment, a payment will be made on your behalf. Both Medicare and Medicaid pay directly to the medical provider that performs the service. The rates of the services performed are discounted for both programs.

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