What is Medicare and Medicaid?

Medicare and Medicaid are both government-run programs, originally designed in 1965 in order to provide health insurance to older and/or low-income Americans. The two different programs are considered “social insurance” programs, which allows financial burdens due to illness to be shared between affluent and low-income participants, as well as both the sick and the healthy. While the two programs appear similar, Medicare is not the same as Medicaid:

Medicare is strictly a federal program that provides health insurance for those 65 and over, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent failure requiring dialysis or a transplant). Click here to find out more information, or whether or not you are eligible.

Different parts of Medicare also help cover specific services:

  • Medicare Part A (Hospital Insurance) – covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B (Medical Insurance) – covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Medicare Part C (Medicare Advantage Plans) – offered by a private company that contracts with Medicare to provide all Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
  • Medicare Part D (prescription drug coverage) – adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.

Medicaid is a state, as well as a federal program, that provides health insurance to millions of low-income families, children, pregnant women, adults without children, and also seniors and people living with disabilities. In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are combined into one program called MassHealth. (Click here for more information)