Medicare and Medicaid

Medicare vs. Medicaid: What’s the Difference?

While both Medicare and Medicaid are government-funded healthcare programs, there are key differences between them. Medicare is primarily for people over 65 or those with certain disabilities, regardless of income level. On the other hand, Medicaid is designed to provide healthcare coverage to low-income individuals and families.

Another difference is that Medicare is federally funded, while Medicaid is funded jointly by federal and state governments. This means that eligibility requirements may vary from state to state when it comes to Medicaid.

Medicare Disability vs. Medicaid Disability

As mentioned earlier, Medicare covers individuals with certain disabilities as well as those over 65 years old. To qualify for Medicare disability benefits, an individual must have received Social Security Disability Insurance (SSDI) for at least two years.

On the other hand, Medicaid provides healthcare coverage for low-income individuals and families, including those with disabilities. Medicaid disability benefits are based on financial need, and eligibility requirements vary from state to state.

What Kind of Medicare Do You Get with Disability?

If you qualify for Medicare due to disability, you will typically be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). These two parts are often referred to as “Original Medicare.”

  • Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health services.

  • Part B covers doctor visits, outpatient care, preventive services, and medical equipment.

In addition to “Original Medicare”, there are also options for additional coverage through private insurance companies. These include:

  • Medicare Advantage (Part C): This option combines Parts A and B into one plan offered by a private insurance company. It may also include additional benefits such as prescription drug coverage or dental/vision/hearing services.

  • Prescription Drug Coverage (Part D): This is a standalone plan that provides coverage for prescription medications.

Medicaid for Disabled Adults

Medicaid provides healthcare coverage for low-income individuals and families who meet certain eligibility requirements. For disabled adults specifically, eligibility is determined by the severity of the disability as well as income level.

In some cases, Medicaid may provide additional benefits beyond basic healthcare coverage, such as personal care services, transportation to medical appointments, and home modifications.

It’s important to note that each state has its own Medicaid program, so eligibility requirements and benefits may vary depending on where you live. Our social security disability law firm can help you navigate the Medicaid system in Texas and determine if you qualify for benefits.

How Disability Action Advocates Can Help You

If you're dealing with a Social Security Disability case, even the smallest issues can hold significant weight. That's why working with an SSD lawyer is beneficial. The legal requirements and language can be extensive and stressful, but a professional lawyer can clarify each point of the process for your best chance at a favorable outcome.

Our team provides personalized guidance throughout every step of the process, from filing paperwork to representing you at your hearing. We have helped many clients in Dallas and Fort Worth, and we want to help you too. Contact Disability Action Advocates today for seasoned legal representation that reduces stress and improves upon any weaknesses in your current file.