Medicaid and Medicare Specialists in Idaho Falls

Understanding The Medicaid and Medicare Program and Reasons for Specialists

Medicaid and Medicare are two government-sponsored systems that deliver medical care and other health-based services to certain persons in the U.S. Medicare is more of a social insurance plan while Medicaid is a social protection or social welfare program.

How a Specialist Helps With the Process

Here at Answers LLC, we are conversant with the intricacies of Medicaid and Medicare and have steered thousands of people in Idaho through the murky waters of our healthcare system. Our Medicaid and Medicare specialists can help you understand your various options and help defend your rights through the entire process.

medicaid and medicare specialists

Eligibility

medicaid

Medicaid Eligibility

Every state has its Medicaid qualifications rules. The main goal of the program is to support low-income individuals. Though there are other requirements that may determine eligibility, including:

  • disability status
  • citizenship
  • age
  • pregnancy status
  • assets

For federal match funding to be disbursed to a state, they are obliged to deliver Medicaid services to people in particular categories of need. The following “categorically needy” people are considered to qualify for Medicaid under the federal government:

  • Persons who get Supplemental Security Income (SSI)
  • Pregnant women with a household income under 138% of the Federal Poverty Level
  • Parents earning a salary that is under the cash assistance’s eligibility in the state
  • Children below 18 years with a household income that’s below or at 138% of the Federal Poverty Level 

Medicare Eligibility

To qualify for Medicare one must meet the following conditions:

  • Aged below 65 years and with a disability
  • Aged above 65 years
  • All ages with permanent kidney failure or final stage renal disease requiring transplant or dialysis

Said persons must also be:

  • An American or permanent legal resident for 5 successive years
  • Qualify for Social Security with a minimum of 10 years of contributing payment 
medicaid

Differences Between Medicaid & Medicare

Medicaid

Medicaid is a medical and health service plan meant to assist low-income households with limited resources. To be eligible, persons must satisfy certain requirements. These conditions vary between states.

Although Medicaid is primarily overseen by federal authorities, every state is obliged to:

  • Administer the plan
  • Set eligibility requirements
  • Set service rate of payment
  • Decide scope, duration, amount, and service type

Medicare

This is a federal health insurance system that supports medical and healthcare for elderly folk in America. Persons with disabilities stand to gain from Medicare.

The program comprises:

  • Part A and B for medical and hospital insurance
  • Part C and D that offers prescription drugs and flexibility

Frequently Asked Questions

Who pays for Medicaid?

Medicaid doesn’t give any cash to people but rather disburses payment to medical care providers directly. The federal contribution rate starts at 50%. The remaining costs are paid by the states and they have autonomy as to what benefits to offer and whom to cover.

Can I be ineligible for Medicaid if I move to a different state?

As long as you’ve met the residency caveats, states are mandated to deliver Medicaid services to qualified residents.

If you want to learn more about your Medicaid and Medicare options, you can call our Answers LLC offices at (208) 552-0855 to begin your journey.

Ready to take the first step?

We are ready and waiting to help you find the answers you are looking for.