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If you are eligible for Medicare, a Medicare Advantage plan may be an option for you.
The words “Medicare” and “Medicaid” are often mistaken for the same program because they sound similar. The two programs are very different AND it is possible to have just one OR both Medicare and Medicaid.
Medicare is a federal program funded by Social Security and run by CMS (Center for Medicare/Medicaid Services). Medicare is a health insurance program for those 65 and older or who have been deemed disabled by Social Security for at least 24 months. Most will be signed up for Medicare when eligible automatically ALTHOUGH many will need to sign up through Social Security. There are four distinct parts of the Medicare program (A, B, C, and D). Medicare is also known as Original Medicare which is a Fee For Service program which pays your providers if they are credentialed to bill Medicare and they provider agrees with Medicare’s terms, conditions, and fee schedule. Original Medicare is identified by its red/white/blue paper identification card. Part C of Medicare is an optional way of receiving your Medicare benefits also known as Medicare Advantage.
Medicaid is both a state and federally funded program that provides health insurance for individuals with very low annual income, certain disabilities, those with long term care needs, pregnant and many children. Typically, in order to qualify for Medicaid you must meet both income and resource guidelines. Think of Medicaid as financial aid and healthcare combined for certain categories of people.
Medicare coverage can differ depending on the plan chosen by the individual. Original Medicare Parts A, B, C and D all entail different types of healthcare coverage. Keep in mind that those who choose Medicare part C are NOT subject to the cost sharing requirements of Medicare part A and B. Those who choose Medicare Part C (Medicare Advantage) have cost sharing requirements in accordance with the plan’s benefits/documents and are subject to change annually. Those who use Medicare as their primary insurance can go to any doctor in the US that accepts Medicare.
Think of Medicare as healthcare for older adults and think of Medicaid as financial aid + healthcare for women, children, and others that meet the income and eligibility guidelines.
Someone can be eligible for Medicaid and not Medicare and the opposite is true. Additionally someone can have both Medicare and Medicaid if they meet the guidelines and apply for both programs.
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. We can get you applied in minutes, screen your eligibility AND answer program questions and handle renewals.
Article written by Heather Majka with Citizens Insurance Solutions