Free Consultation


Medicare and Medicaid: Health Insurance for Disabled and Poor People

Medicare Vs Medicaid

Medicare is a federal health insurance that provides monthly payments to seniors, disabled people, and dialysis patients to allow them afford their medical needs and pay their hospital expenses.

Beneficiaries of this federal insurance, who have contributed to Social Security while they were still working (or at least their parents did), will receive the same amount of payments regardless of their income.

On the other hand, Medicaid, which is provided and managed by individual states, offers medical assistance to people with limited income.

According to insurance lawyers, the amount of Medicaid assistance is based on the beneficiary’s income.

And because Medicaid is mainly for poor people, it does not require beneficiaries to pay premiums or deductibles unlike in Medicare.

Another advantage of Medicaid is that health service providers cannot charge beneficiaries for additional fees beyond the reimbursement amount.

Medicaid: Who is Qualified for This State Insurance?

Unlike in Medicare where only the Social Security beneficiaries are qualified, Medicaid does not require a person to have contribution while they were still working.

Meanwhile, these are the people who are eligible for Medicaid:

  • Low-income families with young children

  • Beneficiaries of Supplemental Security Income (SSI)

  • Babies born to mothers who are eligible to receive Medicaid. (The baby-beneficiaries will continue to receive assistance throughout their first year after birth as long their mothers are Medicaid-eligible or still pregnant.)

  • Children aged 6 and younger who are living below the federal poverty level

  • Pregnant women, regardless of their age, whose family is living below the federal poverty level

Some states extend the Medicaid assistance to these marginalized sectors:

  • Certain seniors, disabled individuals, and blind people who have limited source of income

  • Certain institutionalized individuals who have limited source of income

  • Uninsured or low-income women who have been diagnosed with cervical and breast cancer by the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program

Services Medicaid Beneficiaries can Get

  • Doctor and nurse’s practitioner services

  • Inpatient nursing home care

  • Inpatient and outpatient hospital services

  • Laboratory testing and X-Ray services

  • Home health care services

Apart from these entries, some states provide beneficiaries with medical service from optometrists, podiatrists, psychiatrists, psychologists, dentists, physical therapists, and chiropractors.

Medicaid beneficiaries may also be provided with prescription medicines, transportation services, and eyeglasses as long as these are given by Medicaid-covered health providers.

Applying for Medicaid

Each state handles its own Medicaid program which goes under different names such as Public Aid, Human Services, Public Welfare, Social Services, or something which sounds similar.

To apply for this state-provided health insurance, people should call their state or local agency to ask if they are qualified to receive benefits.

List of Cities and Counties in California