Maryland Elder Law: Understanding the Difference Between Medicare and Medicaid

The issue of healthcare has been a thorn in the back of American taxpayers for a long time. The United States spends a staggering $10,348 per person on healthcare, amounting to about 18% of its GDP. This is far more than any other country on the planet. In fact, it is 8 percentage points clear of the average of the industrialized members of the Organization for Economic Co-Operation and Development.

The good news is that there are two government-funded programs specifically designed for those who cannot afford private healthcare. These are medicare and medicaid. Let’s explore the difference between these two systems.

Medicaid

Medicaid is a healthcare program that was created by the federal government, but is managed by each individual state. Its goal is to help low-income citizens pay for their medical services. Benefits include mental health services, specialized care, eye care, dental, hospitalizations, prescriptions, and primary care. You need to meet certain federal income and asset standards to be eligible for Medicaid, and these standards vary by state.

In Maryland, you can apply for Medicaid at the Department of Health if your combined household income is 138% or below of the Federal Poverty Level. You also need to:

  • Be a Maryland resident
  • Be a US citizen
  • Meet asset requirements (if applying for long term care)
  • Meet medical requirements (if applying for special programs, including long term care)

Medicare

Medicare is a healthcare insurance program that is run by the federal government. It provides healthcare benefits for people aged 65 and above, as well as anyone with certain disabilities and those with permanent kidney failure.

Medicare is divided into two main parts, each offering specific services:

  • Part A (Hospital Insurance) – covers hospice care, inpatient hospital stays, some home health care, and care in a skilled nursing facility
  • Part B (Medical Insurance) – covers medical supplies, outpatient care, certain doctors’ services, and preventive services

Some Medicaid services can overlap with Medicare, such as doctors’ services and hospital care. Unlike Medicaid, Medicare does not cover all medical expenses and it is limited when it comes to long-term care. On the other hand, Medicaid does not have federally-set premiums, coinsurance, or deductibles, and states may set cost sharing requirements or charge premiums for Medicaid applicants. These costs may be more for higher-income earners.

For more information on this and any other elder law issue, the Tyra Law Firm is here for assistance. Our attorneys can advise you on the best healthcare program to enroll in, depending on your personal circumstances. Call us today at (301) 315-0811.

Written by The Tyra Law Firm

Our firm offers a number of legal services, including Family Law, Estate Planning,Elder Law/Medicaid Planning, and Personal Injury. In each of our practice areas, we are committed to paying close personal attention to every detail, and providing excellent client service.