The ABC’s of Medicare and Medicaid

A vs. B, B vs. C, what do they all mean? Medicare plans can be very confusing, so we’ve come up with a simple list and clickable resources to explain what each of these plans entail.

Medicare is a federal program that is associated with social security. It is available to all U.S. citizens 65 years of age or older, people with certain disabilities, and regardless of income.

Medicare Part A: This part is considered Medicare’s hospitalization coverage. It generally includes hospital care, skilled nursing facility care, nursing home care, hospice, and home health services.

Medicare Part B: This is Medicare’s medically necessary coverage, and preventative services used to prevent illnesses or detect it in its’ beginning stages. It includes: clinical research, ambulance services, durable medical equipment, mental health (and inpatient, outpatient and partial hospitalization related to mental health), getting a second opinion before surgery, and limited outpatient prescription drugs.

Medicare Part C: This plan is purchased through private insurance companies who contract with Medicare. It provides Part A and Part B services in addition to prescription drug coverage.

Not sure if your services are covered by Medicare? Check out this tool which helps you determine what is covered and what isn’t! And for more information on Medicare eligibility, coverage, and costs visit Medicare.gov.

How does all of this relate to Medicaid?

Medicaid is insurance coverage that is determined by your income eligibility and is paid for by both state and federal governments. Those who are eligible to enroll in this plan have to meet a maximum income criterion. In Ohio, most individuals who have Medicaid must also join a managed care plan to receive their health care. Managed care plans are health insurance companies that are licensed by the Ohio Department of Insurance and have a provider agreement with the Ohio Department of Medicaid to provide coordinated health care to Medicaid beneficiaries.

Covered services under Medicaid include: Alcohol and drug addiction, dental, emergency, family planning, healthcheck, hospital, medical equipment, mental health, pregnancy, prescriptions, preventative health, professional medical service, transportation, and vision. For a comprehensive explanation of what is covered, who qualifies, and information on different states’ Medicaid programs visit Medicaid.gov. For information on Ohio’s Medicaid program click here.