What is the Difference between Medicare and Medicaid?

Although the names sound similar, Medicaid and Medicare are very different government programs.  Medicare is an “entitlement” health insurance program which makes health insurance available to all individuals over the age of 65 who have paid their Medicare taxes.  It is also available to younger disabled persons who have a work history and have paid their Medicare taxes.

Medicaid is a “need-based” program which helps individuals with Long-term Care.  Medicaid is available to those who can show a medical need for long-term care and who have limited financial resources.

It is important to understand that Medicare does not cover care in an Assisted Living Facility and covers care in a skilled nursing facility up to 100 days of residency.  There are co-pay requirements after the first 20 days, but supplemental insurance can be purchased to cover deductibles and co-pays.  Home care can be covered by Medicare, but only if ordered by a physician.

Medicaid provides very limited coverage for home health care and all Medicaid medical and financial requirements must be met.

Another difference between the two programs is that Medicare is administered totally by the federal government.  Medicaid is a joint program between the federal government and the state.  In Florida, the program is administered by the Florida Department of Children and Families in conjunction with the Florida Department of Elder Affairs.  A Florida Bar Board Certified Elder Law Attorney can assist you in understanding the complex rules which apply to Medicaid eligibility.

Questions? The Law Office of Debra Simms is here to help. Call us today 386.256.4882


This blog post is not case-specific and is provided only for educational purposes and is not intended to provide specific legal advice. Blog topics may or may not be updated and entries may be out-of-date at the time you view them.

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