Medicaid vs. Medicare

A common question that people of all ages wonder is: What is the difference between Medicaid and Medicare? or Which one should I get? Sivia Law wants to help you understand the differences in order to provide you with tools to help make the best choice for you! 

Medicare VS. Medicaid: What’s the difference? 

Even though Medicare and Medicaid sound alike, they are two different forms of health coverage. Medicare is a federally funded health insurance program for people over 65, and those who are under 65 with certain disabilities. Medicare is nationwide and funded through federal, state and local taxes, and Social Security Benefits. Medicaid is a state and federal assistance program that covers pregnant women, children and adults who receive low income. Medicaid varies from state-to-state and is jointly funded by federal and state payroll taxes. 

What do they cover?

Medicare features four parts: A, B, C, and D. There are two forms of Medicare coverage which include Original Medicare and Medicare Advantage. Original Medicare includes Part A which covers hospital services and Part B which covers medical services. Medicare Advantage coverage includes Part A, Part B, and usually Part D which covers prescription drug costs. 





Part C (Medicare Advantage)

This is an alternative to traditional Medicare coverage, and often includes Parts A, B, and D, and may also include some procedures not covered by Medicare such as hearing, vision, and dental. Private insurance companies administer Medicare Advantage plans.



Medicaid benefits vary state to state but some benefits include inpatient and outpatient hospital services, nursing home and home health care, laboratory and x-ray diagnostic services, transport to a medical facility, and tobacco-cessation counseling for pregnant women. They also provide nursing home care and custodial care.



Medicaid can be used as a great tool in areas of estate planning. Many families struggle with how to help their elderly loved ones qualify for Medicaid to cover their long-term care while preserving their estates. This complex and challenging process should be handled by an experienced professional who can explain all of your options, including the benefits and drawbacks of specific strategies. We, at Sivia Law, are deeply familiar with the rules regarding money and property transfers, and the time limitations surrounding when someone enters a nursing home.



Long-term care and Medicaid planning is essential for seniors entering nursing homes. If you, your parent or grandparent is at an age where a nursing home might be in the near future, you probably have many questions and concerns. Will my parents be able to keep his or her assets and money? What expenses will the state of Illinois cover? At Sivia Law, we have answers, and we are prepared to walk you through this life-changing transition.

How can I apply? 

To apply for Medicare, visit Medicare Benefits on the Social Security Administration's website during the open enrollment period, which runs from November 1 - December 15, and submit an application online. 

You can apply for Medicaid and enroll any time of year. Contact your state Medicaid agency for more information or submit an application through the Healthcare.gov Health Insurance Marketplace. The cost of Medicare depends on whichever plan you choose. Medicaid costs depend on your personal income and state rules. 

It is possible to be eligible and receive both Medicare and Medicaid for some low- income elders. Contact your health care provider to see if they qualify for dual eligibility. Both programs will work together to cover most, if not all, of the costs. 

Interested in Working Together?

If you need any help regarding your business or other legal matters please reach out to us directly here and schedule a call with one of our paralegals on our scheduling page here.