Medicare vs. Medicaid

While the two government-funded programs are similar, Medicare and Medicaid are quite different. 

Medicare is designed for those who are under 65 with a disability, or those who are 65 and older, to help cover medical-related costs. The level of income does not determine eligibility. Medicare is also funded by payroll taxes and premiums paid by Medicare beneficiaries. 

Medicaid, on the other hand, is designed for those with low or limited income. Each state has different eligibility requirements. Funding for Medicaid is done through the states and federal government. 

Medicare Coverage

Medicare is divided into several parts: Part A, Part B, Part C, and Part D.

Part A and B, which make up Original Medicare, provide coverage for inpatient and outpatient costs. With Original Medicare, beneficiaries may also enroll in a Medicare Supplement Plan. These plans help cover some of the costs that Original Medicare does not cover. 

Part C provides the same coverage as Original Medicare, but also includes additional coverage, such as dental, vision,  or hearing coverage.

Part D provides prescription drug coverage.

Medicaid Benefits

The benefits vary by state, but the government does mandate coverage for numerous services:

  • Clinic treatment 
  • Doctor services
  • Lab services and x-rays
  • Hospitalization 
  • Family planning and midwife services
  • Pediatric services
  • Family nurse practitioner services 
  • Nursing services
  • Nursing facility services 
  • Home healthcare

Each state may also offer additional benefits:

  • Prescription drug coverage
  • Eyeglasses/optometrist services 
  • Dental services 
  • Prosthetic services
  • Physical therapy 
  • Medical transportation 

In Rhode Island, there are several long-term care programs with Medicaid that seniors can be eligible for. These programs include:

  • Institutional/Nursing Home Medicaid: If you meet the eligibility requirements, you will receive assistance that is only provided within a nursing home facility.
  • Medicaid Waivers/Home and Community Based Services: There are limited enrollment slots available, which may result in a waiting list. However, with these programs, you can receive benefits at home, adult daycare, or in assisted living.
  • Regular Medicaid/Elders and Adults with Disabilities: If you continue to meet eligibility requirements, you will receive assistance. Benefits can be received at home or in an adult daycare.

How to apply for Medicaid in Rhode Island

Individuals can apply online, over the phone by calling the Department of Human Services, or filling out a paper application and mailing to the local DHS. You can also apply in-person at your local DHS office. 

Enrollment in both?

You do have the option to enroll in both programs as long as you are eligible for both. This is known as being dual-eligible. 

To learn more about your eligibility for both Medicare and Medicaid, give CJC Advisors a call today! We can help you determine which program may be best for you.

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