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Medicare & Medicaid Requirements

Medicare and Medicaid are government-run programs that provide health care coverage for low-income people and the elderly. Costs for routine health care, emergencies and medications can become prohibitive for those on low or fixed incomes. Both programs were set up by the federal government. Medicare has the same requirements throughout the country. Medicaid is run by each state government, with varying requirements.

  1. Medicaid Overview

    • Medicaid was set up in the Department of Health and Human Services within the Centers for Medicare and Medicaid Services. The health insurance program helps pay for some or all of the medical bills for those with limited income. According to the website of Nolo Legal Solutions, Medicaid covers inpatient and outpatient services, prescription drugs, preventive care and eyeglasses. Health care is either free, or participants must pay a small co-pay for services.

    Medicaid Requirements

    • Those with low-incomes might qualify for Medicaid programs within their state. Each state's requirements vary, so check your state government website for more information and exact income requirements. Medicaid covers families, single people and the elderly over age 65. In California, Medicaid is called Medi-Cal and includes coverage for those in assistance programs such as Refugee Assistance and Foster Care. This program also covers those who are disabled, under age 21, pregnant or in an intermediate-care home. In Delaware, low-income pregnant women and children under age 19 can use Medicaid if they qualify, as well as low-income uninsured adults ages 19 to 65.

    Medicare Overview

    • Medicare is a federal program that assists the elderly with the cost of medical care and prescription drugs. According to the Centers for Medicare and Medicaid Services, the program includes hospital insurance coverage, medical insurance that covers doctor, laboratory and outpatient services such as medical equipment and supplies. Medicare also offers prescription drug coverage. Participants pay a monthly premium to help keep costs down for medication. Visit your local Social Security office for more coverage information.

    Medicare Requirements

    • This health insurance program is available to those age 65 and older, people under age 65 with certain disabilities and those of any age with kidney failure who require dialysis or a kidney transplant. The program is not based on income, and is available to anyone who meets the requirements. Those on Medicare can also receive Medicaid if they meet those requirements as well.

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