The words “Medicare” and “Medicaid” are so much alike that it’s easy to get confused. To add to the confusion, both are government programs that help people pay for health care. But that’s where the similarities end.
See below for more information about each program and how they compare.
What is Medicare? What is Medicaid?
Medicare is a federal program generally for people who are 65 or older or have a qualifying disability or medical condition. Medicare Part A and Part B are provided by the federal government, and Medicare Part C and Part D, while federally governed, are provided by private insurance companies.
Medicaid is a state government program that helps pay health care costs for people with limited income and resources, and different programs exist for specific populations. Medicaid plans vary from state-to-state but follow federal guidelines for benefits.
What do Medicare and Medicaid cover?
Medicare Part A is hospital insurance and Part B is medical insurance. Medicare Part D is prescription drug coverage, and Part C (Medicare Advantage) is an all-in-one coverage option that combines Parts A, B and D, as well as other benefits that may include items like dental, vision, fitness and hearing. Medicare Part A and Part B coverage is standard, but Part C and Part D will vary based in terms of coverage provided depending on the plan, the insurance provider and your location.
Medicaid programs include federally mandated benefits and optional benefits. Each state decides what optional benefits to include
How much does Medicaid cost? How much does Medicare cost?
Both Medicare and Medicaid may include premiums, deductibles, copays and coinsurance. For Medicare, how much you pay will vary based on when you enroll, what coverage options you select and what health services and items you use throughout the year. For Medicaid, the amount you pay depends on your income and the rules in your specific state. Additionally, some specific groups under Medicaid are exempt from many out-of-pocket costs.
There are also four different Medicare Savings Programs, which are designed to help with the cost of Medicare. If you meet the conditions to qualify for one of these programs, you could get help paying for your Medicare premiums, and in some cases, also get help paying Medicare Part A and Part B deductibles, coinsurance and copayments.
Can you have both Medicare and Medicaid?
Yes, some people can have both Medicare and Medicaid. People who qualify for both Medicare and Medicaid are called “dual eligible.” If you qualify and choose to enroll in both programs, the two can work together to help cover most of your health care costs. You may also be eligible for a special kind of Medicare Advantage plan called a Dual Special Needs Plan. You can learn more about being dual eligible and how Medicare coverage can work for you here.
What are Dual Special Needs Plans (D-SNP)?
Upbeat music plays as the UnitedHealthcare logo becomes ribbons that swoop across the screen. A text bubble pops up.
ON SCREEN TEXT: Dual Special Needs Plans
ON SCREEN TEXT: Medicare Conversations
A document with D-SNP printed at the top appears.
ON SCREEN TEXT: What is a Dual Special Needs Plan (D-SNP)?
A brown-haired woman sits in a chair. Text appears in a blue banner at the bottom of the frame.
ON SCREEN TEXT: Holly Martin Dual Special Needs expert
HOLLY MARTIN: Hello everyone! I’m Holly Martin. And over the last several years, I have worked on bringing education and awareness to Dual Special Needs Plans.
The D-SNP sheet appears against a white background, labelled “What they are.” A magnifying glass appears next to it, labelled “Why they are different.”
HOLLY: We’re gonna take about what Dual Special Needs plans are. We’re gonna talk about why they’re different, they’re a different type of Medicare advantage plan.
An icon of a man appears and is labelled “Who is eligible.”
HOLLY: And we’re gonna talk about who is eligible for them and what to know about whether or not a Dual Special Needs plan might be right for you, or someone you love.
We return to Holly.
HOLLY: So let’s go ahead and get started.
A hand holding two MEDICARE cards appears beside text against a blue background.
ON SCREEN TEXT: What is dual eligibility?
HOLLY: So let’s talk a little bit more on what it means to be dual eligible.
Two cards, labelled Medicare and Medicaid appear against a white background.
HOLLY: Dual eligible simply means that you are both Medicare eligible and Medicaid eligible.
The Medicaid card is pushed aside, and a cake labelled 65 plus appears on the left side of the screen. It is followed by “Or” and a wheelchair icon labelled eighteen plus.
HOLLY: On the Medicare side that means you could have reached the magical age of sixty-five, or that you could have a qualifying disability at ages eighteen years all the way up to age sixty-four.
The Medicaid card takes up the left side of the screen. On the right, a wallet appears, labelled income. A line goes through it, and text appears.
ON SCREEN TEXT: Poverty level
HOLLY: To qualify for Medicaid, it simply means that your income is below the federal poverty level. And that number really varies by state.
Text appears beside a calendar.
ON SCREEN TEXT: When would I enroll?
Text appears against a white background.
ON SCREEN TEXT: Being dual eligible allows you to enroll throughout the year
Text appears at the top of the frame against a white background.
ON SCREEN TEXT: Initial Enrollment Period
Below it, a bar with the months of the year appears, with a checkmark above June. Text appears below the bar.
ON SCREEN TEXT: So, you can enroll when you first become eligible for Medicare.
New text appears above the bar.
ON SCREEN TEXT: Special Enrollment Period
Three checkmarks appear over February, April, and August. New text appears at the bottom.
ON SCREEN TEXT: once per quarter for the first three quarters of the year or during the Medicare Annual Enrollment Period, which is the last quarter of the year.
New text appears above the bar.
ON SCREEN TEXT: Annual Enrollment Period
The bar highlights the section at the end between October and December. A check mark appears above November. Text appears at the bottom.
A magnifying glass appears next to white text against a blue background.
ON SCREEN TEXT: What is a Dual Special Needs Plan?
HOLLY: So what is a dual special needs plan?
The D-NSP sheet appears below text on the left side of the frame.
ON SCREEN TEXT: Medicare Advantage Plan
The Medicare and Medicaid cards appear next to it from the right, with two lines connecting them to the sheet.
HOLLY: A “D-snip” plan is just a special kind of Medicare Advantage plan that is there for those that have both Medicare and Medicaid eligibility.
A pill bottle labelled Part-D enters the frame.
HOLLY: And that Special Medicare Advantage plan takes your Medicare, your Medicaid and your Part D needs and puts them all together in one package to provide you with an overall healthcare experience.
A sheet of paper with D-SNP labelled three times unspools next to text against a blue background.
ON SCREEN TEXT: Are all Dual Special Needs Plans the same?
HOLLY: A dual special needs plan is a Medicare Advantage plan.
Three icons appear. One is of a dollar bill labelled “Costs.” The next is a star labelled “Benefits.” And the third is a checkmark labelled “Coverage.”
HOLLY: And just like all Medicare Advantage plans, the costs, the benefits, and the coverage are going to vary based on who is providing that plan.
A magnifying glass enhances on the D-SNP sheet over a blue background. Text appears next to it.
ON SCREEN TEXT: How are Dual Special Needs Plans unique?
HOLLY: Dual special needs plans are unique in that they provide extra benefits.
The Medicare and Medicaid cards slide on screen next to a full pill bottle labelled Part D. A star icon slides on screen next to them labelled “Special Benefits.”
HOLLY: So along with providing you your Medicare, your Medicaid and your Part D coverage, they also offer you extra benefits that help you utilize that healthcare coverage.
A stethoscope icon appears with a car driving along on it. At the end is a destination pin with text above it.
ON SCREEN TEXT: Transportation.
HOLLY: Things like transportation, to make sure that you get to your doctor visit safely and on time.
The frame is divided into four quadrants. The transportation pin moves to the top left. On the top right, a pair of glasses labelled “Vision” appears. A toothbrush labelled “Dental” is in the bottom left, and a collection of Vitamins and creams in the bottom right is labelled “OTC credits.”
HOLLY: They can also be things like dental and vision coverage. Or perhaps credits to help you purchase over-the-counter products.
A piggy bank appears next to text against a blue background.
ON SCREEN TEXT: Are there any costs with D-SNP plans?
HOLLY: “D-SNP” plans typically come at no additional cost to you. However the costs of a D-SNP plan are going to depend on your Medicaid eligibility levels.
The Medicare and Medicaid cards appear against a blue background, along with a pill bottle labelled Part D.
A zero dollars label appears over each icon.
HOLLY: So right now for example, if you’re not paying anything for your Medicare, and your Medicaid, and your Part D, what’s so great about a D-SNP plan is you can join that plan, you won’t lose any of those benefits that you currently have.
The icons converge and turn into a D-SNP sheet, also labelled zero dollars.
HOLLY: And you won’t pay any more to be apart of a D-SNP plan and gain all of the extra benefits we just talked about, as well as that coordination of care.
Text appears next to a lightbulb against a blue background.
ON SCREEN TEXT: What if I still have questions?
HOLLY: So, we’ve learned a little bit about Dual Special Needs Plans today, and if you’d like to learn even more, visit us online. Thanks for watching.
ON SCREEN TEXT: Visit MedicareMadeClear.com
ON SCREEN TEXT: Medicare Made Clear brought to you by UnitedHealthcare
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ON SCREEN TEXT: UnitedHealthcare®
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Medicare Made Clear brought to you by UnitedHealthcare provides Medicare education so you can make informed decisions about your health and Medicare coverage.