Learn Common Misconceptions About Medicaid and Medicare

Understanding health care is something that is unfortunately very complicated. There are a lot of different health care programs available, many of which are undergoing changes. Some programs are removed entirely, while others have experienced drastic changes. Two of the biggest health care programs currently in the United States are Medicaid and Medicare.

There is often a lot of confusion regarding exactly what Medicaid and Medicare do. In fact, one of the most common misconceptions regarding the two programs is that they are both different programs. Because of the similar names, many residents make the mistake of thinking they are a singular program, and will use the names interchangeably.

While the names are very similar, the programs have very different purposes. Medicaid is a need based health care program, primarily available to lower income applicants and applicants with disabilities. Medicare is a health care program available to applicants over the age of 65. Medicare is divided into several different plans, each of which offers different coverage and costs.

Both Medicare and Medicaid are very helpful health programs, but it is important for beneficiaries to understand exactly what the programs provide, and not be confused by common misconceptions.

Information About Receiving Benefits from Both Programs

One of the misconceptions regarding Medicaid and Medicare is that the programs are not compatible. This misconception likely comes from the eligibility requirements for the program. Medicare is available to anyone over the age of 65 or to beneficiaries with specific disabilities. Medicaid does not have a specific age limit, but many people mistakenly believe that Medicaid beneficiaries lose their benefits once they become eligible for Medicare coverage.

It is possible for beneficiaries to receive both Medicare and Medicaid coverage at the same time, as long as they meet the eligibility requirements for both programs. This is very important for older beneficiaries to take into consideration, since it gives them more freedom in selecting a Medicare program, as many other benefits are covered through Medicaid.

Learn About Federal Medicaid

Another one of the most common misconceptions regarding Medicaid comes from the coverage. Medicaid is partially funded by the federal government, which leads to many residents mistakenly believing that Medicaid is also a federal program. Medicaid is a state sponsored program.

It may not seem like this is a big deal, but it creates a lot of different rule changes for Medicaid. Federal programs all share the same rules throughout the country, but state run programs work differently. Each state is allowed to make changes to the program, so Medicaid in Alabama is different from Medicaid in Florida. One of the biggest differences is whether or not each state wants to accept the expanded Medicaid program, which changes the general eligibility requirements for Medicaid. Expanded Medicaid was made optional for states.

How to Enroll in Medicare

One of the more confusing aspects about Medicare comes from the different sign up periods. Unfortunately, this has led to the misconception that anyone is able to sign up for Medicare whenever they want, which is not the case. There are a few different eligibility dates for Medicare. There is an early enrollment period, a standard enrollment and a special enrollment period. In addition, applicants that are about to turn 65 have a special initial enrollment period.

Medicare enrollment is very confusing, but potential applicants are alerted by mail about eligibility several months before they turn 65, so they have plenty of time to figure out the correct enrollment dates for the year, and what information they need to apply. Fortunately, many applicants are automatically enrolled into Medicare coverage, which simplifies the process.

Applicants that miss the initial eligibility periods may still be able to apply, but they will have to wait longer to receive Medicare coverage. Applicants with extenuating circumstances for not applying during the initial periods may be able to apply for special enrollment.

How extensive is Medicare coverage?

There are several misconceptions regarding how extensive Medicare coverage is. Many Medicare beneficiaries make the mistake of believing that Medicare will cover all of their costs. This confusion likely stems from how similar the name is to Medicaid, which is a program that provides many more health care benefits. Medicare coverage is divided into separate plans, with each plan providing coverage in different areas. For example, Medicare Part D is an optional part of Medicare which is exclusively for prescription drug costs.

Medicare beneficiaries are not limited to a single Medicare plan. It is not uncommon for beneficiaries to enroll in multiple Medicare plans to get the most coverage possible. It is very important for applicants to look over each individual Medicare plan and not just assume that there is one base plan which provides general health care.

What does Medicare cost?

Another common misconception with Medicare has to do with the cost. Many applicants believe that Medicare does not cost them anything. Technically, part of this is true. The majority of applicants are eligible for free Medicare Part A coverage. Part A coverage is available to beneficiaries receiving Social Security or railroad retirement benefits. This coverage is for hospitalization and limited outpatient services. This free coverage is specifically for Part A and does not apply to any other Medicare plans, which all have different costs. Other parts which come with associated costs include Medicare Part B, Part C (Medicate Advantage), and Part D. Each of the plans also calculates payments in different ways. For example, Medicare Part B-D uses a premium payment option, with the payments largely dictated by the issuing insurance agency.