What is the difference between Medicaid and Medicare?

One of the most common questions we get at Monteforte Law is “What is the difference between Medicaid and Medicare? Aren’t they the same?” the short answer is NO! They are actually VERY different programs, so to make it easy here is a very simplified description of each and the benefits they offer. 

Medicare 

Medicare is an insurance program offered nationwide by the federal government. Medicare is provided for people over the age of 65 no matter what their income is. The short description is that Medicare is health insurance, offered by the government, to help cover medical expenses. The coverage is broken into several “Parts”. For example, Medicare Part A covers inpatient treatment, while Part B covers outpatient treatment. Part D helps with the cost of medication.

Medicare also serves younger disabled individuals and dialysis patients. With Medicare coverage, patients only pay part of their medical expenses, through the use of a “deductible” for hospital stays and other medical costs. With Medicare, small monthly premiums are required for non-hospital coverage. 

Medicare At Monteforte Law, we do not help clients with Medicare applications, since they are insurance-based and not long-term care based. You can apply for Medicare online here: www.ssa.gov/medicare, and it only takes about 10 minutes. Additional supplemental plans are available through the use of an insurance agent.

The Medicare application is not something that generally gets rejected or challenged, and if it is, it’s usually for simple fixes. There are some law firms that handle Medicare appeals, if a medical expenses is rejected, but our law firm does not handle those appeals, because our expertise lies in the long term care part of things. 

Medicaid 

Medicaid is also a federal program offered nationwide. In Massachusetts, the program is administered through MassHealth. This is an assistance program that serves low-income people typically over the age of 65, or otherwise disabled. Like Medicare, Medicaid is broken up into different types of coverage. What we focus on at Monteforte Law is Medicaid applications for for long-term care, be it in-home care or facility-based care, such as nursing home care and personal care services in the home. While it is a federal program, it is administered differently in each state. In Massachusetts, we have to deal with MassHealth, who puts its own spin on the federal program. Unlike Medicare, the application for Medicaid through MassHealth is a VERY difficult process if you do not know what you are doing. And why would you know what you’re doing, unless you’ve been trained to know? 

If you complete the application incorrectly, you can do irreparable harm to the person seeking benefits. Some mistakes cannot be fixed later, and opportunities for benefits, especially retroactive benefits, can be lost for good. If you make a mistake on your application, not only do you risk denial, but you also can risk liens on your home. The application is lengthy, cumbersome, confusing, and requires years of documents. It needs to be done right, the first time, by someone that knows how to do it. This is where our expertise comes in.

Monteforte Law, P.C. can help you with your MassHealth Medicaid Application! Learn more about Medicaid and why having specialists like us on your side makes a very big difference here. 

If you want help with your Medicaid application, book a Strategic Planning Session today to have a one-hour session with one of our attorneys. To learn more about the application process, download a copy of Attorney Monteforte’s book on the Medicaid application process HERE.