Medicare vs Medicaid

The words “Medicare” and “Medicaid” are thrown around often, both in the news and in casual conversation. The confusion over the two terms may come from how similar the words are to one another. As much as they are talked about, it is not uncommon to hear them interchanged incorrectly or used in the wrong context.

Starting with the basics

Medicare is, by definition, a federal program that provides healthcare coverage for the following categories regardless of what their income is or was.

• Individuals 65 and older
• Certain younger people with disabilities
• People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)

Medicaid is both a state and federal program that provides healthcare coverage for individuals with very low annual income. Both programs are funded by the U.S. government with the intent of bringing affordable healthcare to those in need in our country.

What the programs cover

Medicare coverage can differ depending on the plan chosen by the individual. Medicare Parts A, B, C and D all entail different types of healthcare coverage.

• Part A: Hospital Insurance – services/care received as an inpatient
• Part B: Medical Insurance – services/care received as an outpatient
• Part C: Medicare Advantage Plans (coverage plans offered by private insurance companies contracted with Medicare)
• Part D: Prescription Drug Coverage

Since each state has their own Medicaid program, the coverage differs around the country. However, the mandatory benefits each state must include:

• Services/care received in a hospital or nursing facility
• Services/care received in a federally-qualified health center that is licensed or recognized by that state
• Services/care pertaining to certified pediatric and family nurse practitioners

How Medicare and Medicaid pertain to you

You are eligible to enroll in Medicare when you turn 65. It helps to start learning about your Medicare options a year or so before your 65th birthday. Enrollment for Medicaid is different in every state. To find out if you are eligible for Medicaid, contact the Medical Assistance Office in your home state.

TennCare is the state of Tennessee’s Medicaid program and a great resource to take advance of if you are in need and eligible. Different groups of people qualify for TennCare including low-income pregnant women, caretakers of a minor child, individuals with a disability, and more. Our agents are available to walk you through the process and help you apply for TennCare at no cost to you.

SFG Medicare

We have helped over 30,000 people with their Medicare and Medicaid plans. To schedule an appointment with one of our expert agents, call (865) 777-0153 or request a no-cost consultation. We look forward to welcoming you into the SFG family!