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Conoce los datos sobre Medicare versus Medicaid

Medicare vs Medicaid: they are different, but both help people access health care. Learn how each program works and see if one or both of them can help you with health care coverage.

The difference between Medicare and Medicaid

Medicaid is designed for people with low-incomes

One difference between Medicare and Medicaid is that Medicaid is a public aid health insurance program for people with low incomes of any age. The government funds Medicaid at both state and federal levels. Medicaid offers federally mandated benefits including inpatient and outpatient medical services such as hospitalization, lab work, X-rays and doctor visits.

Other Medicaid benefits vary by state. These may include prescription drugs, case management, physical therapy and occupational therapy. You can enroll in Medicaid if you meet low-income and other eligibility requirements, which vary from state to state.

Medicare mainly serves people 65 and older

Another difference between Medicare and Medicaid is that Medicare is a federally funded program that provides health insurance for people 65 and older and for individuals with certain disabilities.

Medicare plans come in four parts. Part A and Part B, also known as Original Medicare, work together to cover most of the inpatient and outpatient medical needs of beneficiaries. Part C and Part D, available through private insurers, provide coverage beyond what is included with Part A and Part B.

¿Qué cubre Medicare Parte A?
Medicare Part A is your hospitalization insurance. Medicare Part A includes:
  • Estadías en hospital (habitaciones semiprivadas) hasta 60 días
  • Comidas en el hospital
  • Servicios de enfermería
  • Servicios de cuidados médicos intensivos
  • Medicamentos, suministros médicos y equipos usados en las instalaciones
  • Pruebas de laboratorio y radiografías realizadas durante una internación
  • Costos de cirugías y recuperación
  • Servicios de rehabilitación y terapia
  • Cuidados de enfermería a domicilio de tiempo parcial
What does Medicare Part B cover?
Medicare Part B provides for outpatient medical needs. Medicare Part B includes:
  • Routine doctor visits
  • Tests, screenings and X-rays
  • Flu shots and other vaccinations
  • Necessary medical supplies
  • Atención de la salud mental para pacientes ambulatorios
  • Medically necessary preventive care

What do Medicare Part C and Part D cover?
You can add more coverage to your Original Medicare with Part C and Part D plans, which are offered through private insurers like Anthem. You can choose one or the other, but not both. Part C, or Medicare Advantage plans, offers Part A and Part B coverage and may offer extra benefits including:

  • Cobertura de medicamentos recetados
  • Routine dental care including cleanings, X-rays and dentures
  • Routine vision care including contacts and glasses
  • Routine hearing care including hearing aids
  • Fitness benefits including exercise classes

Part D plans only offer prescription drug coverage. These plans are a good option when you just need drug coverage added to your Original Medicare.

How Medicare and Medicaid work together

If you're 65 or older and meet your state's income requirements for Medicaid, you can sign up for both Medicare and Medicaid to get affordable health care coverage. Medicaid helps cover costs that Medicare doesn't.

View Medicaid as secondary health insurance

While Medicare is the primary payer for medical needs, Medicaid can cover costs that Medicare coverage does not. When you visit a provider that takes both Medicare and Medicaid, Medicare pays first for the cost of your care. Medicaid pays second, covering copays and other costs not covered.

If you qualify for both Medicare and Medicaid, you're likely eligible for the Qualified Medicare Beneficiary (QMB) Program, one of four Medicare Savings programs. With the QMB program, you'll get help with Part A and Part B premiums, coinsurance and deductibles.

Apply as a dual eligible

Dual eligibles are people who qualify for both Medicare and Medicaid coverage. If you’re enrolling in Medicare at 65 and qualify for financial assistance, you can sign up for Original Medicare or Medicare Advantage as a dual eligible. You get the health care coverage you need while also getting help for additional health care costs.

Now that you know the facts, you can explore Medicare plans.
Find coverage that fits you.

Busca hoy planes de Medicare

Y0114_20_113219_U   Aceptado por los CMS el 9/10/19

Anthem Blue Cross and Blue Shield es el nombre comercial de: en Colorado, Rocky Mountain Hospital and Medical Service, Inc. Los productos del plan HMO están suscritos por HMO Colorado, Inc. En Connecticut: Anthem Health Plans, Inc. En Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. En Indiana: Anthem Insurance Companies, Inc. En Kentucky: Anthem Health Plans of Kentucky, Inc. En Maine: Anthem Health Plans of Maine, Inc. En Misuri (a excepción de 30 condados del área de Kansas City​​​​​​​): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC) y HMO Missouri, Inc. RIT y ciertas afiliadas administran los beneficios que no son del plan HMO suscritos por HALIC y los beneficios del plan HMO suscritos por HMO Missouri, Inc. RIT; y ciertas afiliadas solo prestan servicios administrativos a planes autofinanciados y no suscriben beneficios. En Nevada: Rocky Mountain Hospital y Medical Service, Inc. Los productos del plan HMO están suscritos por HMO Colorado, Inc., cuyo nombre comercial es HMO Nevada. En New Hampshire: Anthem Health Plans of New Hampshire, Inc. Los planes HMO están administrados por Anthem Health Plans of New Hampshire, Inc. y suscritos por Matthew Thornton Health Plan, Inc. En Ohio: Community Insurance Company. En Virginia: Anthem Health Plans of Virginia, Inc. opera comercialmente con el nombre Anthem Blue Cross and Blue Shield en Virginia, y su área de servicio abarca todo Virginia con excepción de Fairfax, Vienna y el área este de State Route 123. En Wisconsin: Blue Cross Blue Shield of Wisconsin (“BCBSWI”), que suscribe o administra las pólizas del plan PPO y las pólizas de indemnización, y suscribe los beneficios fuera de la red de las pólizas POS ofrecidas por Compcare o WCIC; Compcare Health Services Insurance Corporation (Compcare) suscribe o administra las pólizas HMO y Wisconsin Collaborative Insurance Company (WCIC) suscribe o administra las pólizas HMO o POS de Well Priority. Licenciatarios independientes de Blue Cross and Blue Shield Association. Anthem es una marca comercial registrada de Anthem Insurance Companies, Inc. Los nombres y los símbolos de Blue Cross and Blue Shield son marcas comerciales registradas de Blue Cross and Blue Shield Association. La utilización de los sitios web de Anthem constituye su aceptación de nuestros términos de uso.