Medicare and Medicaid are government-sponsored programs meant to help American citizens pay their healthcare costs. However, they are funded and operated by different government bodies and cover distinct groups. Eligibility requirements can also be confusing, occasionally requiring the assistance of an experienced lawyer to sort out problems. Here's how these healthcare programs work and how they differ from each other.

What is Medicare?

This federal health insurance program generally provides coverage to U.S. citizens aged 65 years or older, regardless of their income. Younger individuals with specific disabilities may also claim Medicare. The Centers for Medicare & Medicaid Services runs Medicare and follows uniform national rules.

There are four types of Medicare plans that eligible citizens can sign up for. Parts A, B, and D offer coverage for hospitals, doctors, and prescription drugs, respectively. Part C, also known as the Medicare Advantage plan, may include all three benefits.

Medicare Part A is free for individuals who paid for Medicare payroll taxes for 40 quarters while they were employed, or are married to someone who has done so. On the other hand, availing Medicare Part B requires payment of a monthly premium. Private insurers offer parts C and D, so their costs vary depending on the insurance company and the level of coverage.

How is Medicaid different from Medicare?

Medicaid covers low-income individuals regardless of age, and each state administers it to its citizens. Eligibility requirements vary per residence and are stricter and more complex than Medicare's. Medicaid coverage can be provided either by the state or a private insurance company. Although the exact benefits differ by state, the federal government requires certain services to be covered, such as hospitalization, X-rays, laboratory services, home health care, maternity and pediatric services, nursing services, and preventive care. 

In some instances, a denial for Medicaid service occurs, or there are disagreements over payment. In these situations, lawyers knowledgeable in Medicaid law are usually called in to help in the appeal process. A lawyer may also be needed when an application is held up in the system, and nothing happens for a considerable time.

It's easy to commit a mistake when you don't have a good grasp of the complex Medicaid system. A dedicated and skilled lawyer from the Rutherford Law Office in Chillicothe, OH, can provide reliable legal representation and help ensure you receive the benefits you are entitled to. In addition to Medicaid and long-term care planning, their lawyers specialize in family law, estate planning, civil litigation, and divorce law. Call them at (740) 775-7434 to discuss your case today, or visit their website to learn more about their services.