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Medicare and Medicaid in Michigan

Medicare and Medicaid were both created through the passing of the Social Security Act of 1965. However, the two programs are targeted at different populations, have different sets of benefits and have different eligibility requirements. Medicare is sold and governed at the federal level, while Medicaid programs are designed by the states, and must meet federal standards. Michigan's Medicaid and Medicare programs had almost the same number of beneficiaries as of 2010, but Medicare is overseen by the Office of Services to the Aging and Medicaid by the Department of Community Health.

  1. Eligibility

    • Medicare is designed to be used mainly by senior citizens aged 65 or older. You may also qualify if you are younger than 65 if you are eligible for Social Security disability benefits. Once you are eligible, you can sign up for Medicare through your local Social Security Administration office. Social Security Online has a list of all SSA offices in Michigan, arranged by county. You can be any age and qualify for Medicaid. In fact, most Medicaid users in Michigan are children. You must be a citizen or legal resident of the U.S. to be eligible for either program.

    Income Limits

    • Medicare has no income limits or asset restrictions, although you may pay higher premiums for Part B if you fall into a high income bracket. You cannot qualify for Medicaid at all if you exceed a certain monthly income limit. The income limit is based on the current federal poverty guidelines. As of 2011, Medicaid participants must make less then 185 percent of the federal poverty level. MIChild, the state children health insurance program, requires that families make more than 150 percent of the federal poverty level but less than 200 percent.

    Costs

    • Medicare comes in four parts. Not all are necessary, but they each come with their own out-of-pocket costs. Part A is often premium-free, but it still has deductibles, copays and coinsurance. Parts B, C and D also have their own premiums, deductibles and copays. The out-of-pocket costs for Medicaid depend on which program you use. There are no premiums at all for for Healthy Kids, the state Medicaid program for children.

    Benefits

    • The benefits you receive through Michigan Medicaid depend on which program you use. Healthy Kids and the Under 21 program offer comprehensive benefits, including mental health, vision and dental services. Medicaid for the elderly, disabled and blind is also comprehensive. Healthy Kids for Pregnant Women and Group 2 Pregnant Women are mainly used for prenatal and postpartum care. Each part of Medicare has its own benefits. Part A covers inpatient hospitalizations, home health and hospice care, and Part B covers outpatient services and preventive care. Part C, Medicare Advantage, mostly allows users to buy their Part A and B benefits from private insurance companies, but may also offer extra benefits such as prescription drugs and vision. Part D Medicare covers prescription medications only.

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