The Differences Between Medicare and Medicaid
While Medicare and Medicaid programs complement each other in certain instances, these two programs are more in contrast to each other. One can be very broad while the other is quite limited. Knowledge on the distinctions between Medicare and Medicaid are very important.
You might find yourself qualified for either or both and such knowledge will empower you to make the right decisions as you enroll.
Video: Understanding Medicare & Medicaid
Medicare vs. Medicaid
1. As to Legal Provision
The policy on Medicare is found in Title XVIII of the Social Security Act while Medicaid is found in Title IX of the same act.
2. As to Eligibility
Eligibility in Medicare is not based on income. Those aged 65 and above are qualified for this program. For those under 65, eligibility is determined by disability or certain health conditions. Medicaid, on the other hand, focuses on income and any person of any age may apply, subject to certain requirements.
3. As to Premium for Enrollment
While Medicare Part A is free, the other plans for additional coverage require premium payments as well as coinsurance or co-payments. This is not true for Medicaid although "spend down" requirements are applicable on some.
4. As to Administration
Medicare is run by the Federal government with previously approved private insurance companies who offer additional plans for members. Medicaid, on other hand, is regulated by state governments subject to policies laid out by the federal government.
5. As to Coverage on AAC Evaluations
Medicare covers AAC evaluations as an SLP service. While it is also true for Medicaid, only children are fully eligible. Adults evaluation is conditioned on whether their respective states cover such evaluations for adults.
6. As to Coverage on AAC Devices
This is covered by Medicare in the form of durable medical equipment. The same is true for Medicaid but with an added option of treating such either as prosthetic device or under the benefit of SLP.
7. As to Documents Required to Claim
The following are required to claim under Medicare: report on SLP, prescription by a doctor, beneficiary's payment or co-payment, and other required forms. For Medicaid, only the report on SLP and the prescription issued by a doctor are deemed sufficient to stage a claim.
8. As to Processing of the Claims
For actions for reimbursement, it is necessary that it be made after the delivery of the device and the charges have been incurred. For Medicaid, the claims instituted for "prior approval" must be made prior to the delivery of the device and the incurred charges.
Video: President's Budget to Cut Medicare & Medicaid
9. As to Payments
Medicare payments may be made either to the beneficiary or to the supplier. Medicaid payments can only be made to the supplier.
10. As to Amounts Covered by Payments
For Medicare, a schedule of fees was prepared for certain devices that are technologically similar. For Medicaid, payments are usually by the full amount or a certain percentage of retail cost for each device.
11. As to Co-payments Given By Beneficiaries
This co-payment is mandatory for Medicare while the same is not applicable for Medicaid with certain exceptions. If there is, it should be for a minimal amount.
12. As to Cost of Co-payments
For Medicare, the amount of co-payment can be 20% of the actual charge or the amount in the schedule of fees or payment of the full charge. The same is not true for Medicaid. If there is, it should be for a minimal amount.
13. Exhaustion of Administrative Remedies
Medicare requires five steps to appeal while Medicaid only has a maximum of two steps.
14. As to Jurisdiction of the Courts
Medicare is only reviewed by federal courts while Medicaid is reviewable in state or federal courts.
15. 
As to Source of Funding
Medicare is wholly funded by the federal government. Half of the funds for Medicaid come from the states.
16. As to Benefits Received
Medicare primarily covers basic hospitalization service while Medicaid covers beyond hospitalization and pays for those services that Medicare cannot cover.
17. As to Membership
Not everyone may enroll for Medicare. Only those ages 65 and older are automatically eligible. Few exceptions would admit those under 65. While not everyone is qualified for Medicaid, almost anybody under the key eligible groups may qualify.