• Tel (781) 344-2886
  • Email info@brc-law.com

Law Offices of Barry R. Crimmins

Barry Crimmins

  • Practice Areas
  • Firm Overview
    • News
  • Current Projects
  • Blog
  • Contact Us
    • Stoughton, MA
    • Hyannis, MA
    • Falmouth, MA
Slide background
Legal Expertise, Personally.
Attorney Barry R. Crimmins is someone that you can depend on personally.
We take a small town approach to our client relationships and carry that personal
commitment into all of our cases.
Slide background
Life Happens. We Help You Plan For It.
The many stages of life present a variety of legal implications. Guidance on
Estate Planning and Administration, Medicaid and Elder Law issues are our focus.
Slide background
Real Estate Transactions, Permitting and
Development.
Whether commercial or residential, we have extensive experience in all aspects
of real estate law.

What Is the Difference Between Medicaid and Medicare?

December 14, 2022 By Barry Crimmins

Senior woman looking confused while reading document at her desk.Although Medicaid and Medicare are both public health insurance programs, they have essential differences.

Medicare is a federal program for older adults, people with disabilities, and individuals with end-stage renal failure. Medicaid is federal-state assistance for those with limited incomes.

History of Medicaid and Medicare

Congress amended the Social Security Act in 1965, creating health care programs for older adults and those receiving public assistance.

  • Providing health care aid for low-income people, Title XIX formed Medicaid.
  • Title XVII established Medicare, offering public health insurance for people aged 65 and older In 1973, the legislature widened the scope of Medicare to help certain disabled persons and individuals with kidney disease.

Roles of States and the Federal Government

The states and federal government play different roles in administering Medicare and Medicaid, according to the U.S. Department of Health and Human Services.

Medicare

Medicare is a federal program that the Centers for Medicare & Medicaid Services runs, so it is consistent across states.

Funding for Medicare comes from general federal revenues, payroll tax revenues, and beneficiaries’ premiums.

Medicaid

Although the federal government sets the general rules for Medicaid, states administer the program, leading to variability across jurisdictions. For Medicaid, states can establish different qualification requirements within federal guidelines.

States and the federal government jointly subsidize Medicaid, per Medicaid.gov. Federal Medical Assistance Percentages determine how much money the federal government matches each state in support of Medicaid.

Qualifying for Medicare

Generally, after paying income taxes for 10 years, a person and their spouse can enroll in Medicare upon turning 65.

Qualifying individuals with disabilities do not have to wait until retirement age to enroll in Medicare. For example, people eligible for Social Security Disability Insurance can also receive Medicare after a two-year waiting period. Those with end-stage renal disease can obtain Medicare at any age if they, their spouse, or their parent if they are a dependent child, have worked the required amount.

Qualifying for Medicaid

Medicaid primarily benefits people with limited earnings. As states run Medicaid, the enrollment requirements can vary by state. Review the eligibility requirements for your state using Medicaid.gov’s state overview feature.

There are multiple pathways to Medicaid, as the Kaiser Family Foundation explains. States must allow low-income parents, children, and those who are pregnant to qualify for Medicaid if their income falls below a certain threshold. This threshold is calculated using the Modified Adjusted Gross Income (MAGI) financial method. Those who received foster care as children can get Medicaid regardless of income.

The basis for eligibility can stem from enrollment in other programs, such as Supplemental Security Income or the Breast and Cervical Cancer Treatment and Prevention Program. States can also allow older people and individuals with disabilities to qualify for Medicaid, imposing both income and asset limits.

In some states, those with medical expenses greatly diminishing their net incomes can qualify for Medicaid under the Medically Needy Program. People with income exceeding the threshold for Medicaid but with medical expenses that reduce their net income below Medicaid’s limit can receive coverage for the costs they cannot afford.

Do Medicaid or Medicare Fund Long-Term Care?

While Medicare covers hospitalizations, short-term care in a skilled nursing facility, and hospice care, it does not fund long-term care. Medicaid covers long-term care in nursing homes, according to the American Council on Aging.

Some older adults can enroll in both Medicare and Medicaid for greater coverage of their health care needs. For instance, one might have Medicare covering hospitalizations and Medicaid covering long-term care.

To learn more about qualifying for Medicare or Medicaid, speak to an elder law attorney.

Filed Under: blogs

Contact Us Today

  • We are happy to discuss any legal concerns with you.
  • This field is for validation purposes and should be left unchanged.
Communication of information through this website does not create an attorney-client relationship.

Recent Posts

BRC Newsletter September

Elder Law News, September 2022

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

august newsletter

Elder Law News, August 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law News - May 2022 Thumbnail

Elder Law News, May 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law NEWS - April 2022

Elder Law News, April 2022

In 2022, change remains constant. But, as it applies to eldercare, some shifts are favorable, while others could directly impact the financial stability and level of care your loved one receives. 

Elder Law NEWS - March 2022

Elder Law News, March 2022

If you or a loved one were hospitalized and put under observation status, don’t worry – you have the right to appeal. The CMS (Centers for Medicare & Medicaid Services) recently announced that beneficiaries could appeal a hospital’s decision to assign observation status.

Our expertise includes Real Estate Law and Land Use Permitting, Estate Planning and Estate Administration, with an emphasis on Elder Law and Medicaid Planning.
Practice Areas
We've developed a reputation for excellent service in these areas of the law through more than 35 years of experience.
Our Attorneys
The legal services from the Law Offices of Barry R. Crimmins, P.C. in Stoughton, Falmouth and Hyannis Massachusetts
Our Locations

Recent News

Law Offices of Barry R. Crimmins, PC

BRC Newsletter September

Elder Law News, September 2022

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

august newsletter

Elder Law News, August 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law News - May 2022 Thumbnail

Elder Law News, May 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law NEWS - April 2022

Elder Law News, April 2022

In 2022, change remains constant. But, as it applies to eldercare, some shifts are favorable, while others could directly impact the financial stability and level of care your loved one receives. 

Elder Law NEWS - March 2022

Elder Law News, March 2022

If you or a loved one were hospitalized and put under observation status, don’t worry – you have the right to appeal. The CMS (Centers for Medicare & Medicaid Services) recently announced that beneficiaries could appeal a hospital’s decision to assign observation status.

Links

  • Home
  • News
  • Site map
  • Privacy Policy
  • Terms & Conditions

Contact Us

  • 909 Washington Street, Stoughton, MA 02072
  • 1436 Iyannough Road, Hyannis, MA 02601
  • 20 Academy Lane, Falmouth, MA 02540
  • Phone: (781) 344-2886
  • Email: info@brc-law.com

Follow Us:

  • facebook
  • twitter
  • linkedin

Estate Planning

  • Estate Planning
  • Estate Administration
  • Elder Law
  • Medicaid Planning

Real Estate

  • Land Use Permitting
  • Landlord – Tenant
  • Purchase & Sale Agreements
© Copyright 2023 Law Offices of Barry R. Crimmins, P.C. All rights reserved.
Site Maintained by Interactive Palette