Florida Medicare vs. Medicaid – What Is the Difference? (2024)

FAQs

Florida Medicare vs. Medicaid – What Is the Difference? ›

Medicare is funded by Social Security tax contributions (FICA). Unlike Medicaid, Medicare is an entitlement program that most senior citizens enroll in at age 65. Florida Medicaid is a needs-based program with benefits determined by the individual's financial and medical position.

Medicare is a federal health insurance entitlement program funded by Social Security tax contributions. Medicaid works as a needs-based program that varies from state to state and operates in partnership with the federal government.

What's the difference between Medicare & Medicaid? Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

The income threshold changes every January 1st. As of January 1, 2024, the LTC Medicaid Income Cap in Florida is: $2,829.00 per month. All sources of income are added up together (i.e. Social Security, IRA / 401k / 403b distributions, annuity payments, pensions, rental income, etc...).

Medicaid is generally free or nearly free, while Medicare has premiums, copays, coinsurance and deductibles.

People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you're a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.

Medicaid covers Part A (if any) and Part B premiums. copayments for Medicare-covered items and services. Even if Medicaid doesn't fully cover these charges, the QMB isn't liable for them. Income can be up to 100% of the federal poverty level (FPL).

Actually, there are two core differences: who administers the program and who can enroll. Medicare is managed by the federal government and eligibility is based on age or disability. Medicaid is managed by each individual state and eligibility depends on income.

Covers certain doctors' services, outpatient care, medical supplies, and preventive services. . Original Medicare covers most, but not all of the costs for approved health care services and supplies. After you meet your deductible, you pay your share of costs for services and supplies as you get them.

Does social security count as income for Medicaid in Florida? ›

For Medicaid eligibility purposes, nearly any income from any source that a Medicaid applicant receives is counted towards the limit. Examples include employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends.

To be eligible, you must be 65 or older (if under 65, disabled or blind), a U.S. citizen or qualified non-citizen, and be medically needy (need the assistance of another in order to perform activities of daily living (ADLs).

Florida has allowed individuals to remain on Medicaid throughout the PHE even though their household situation may have changed. As a result of federal legislative changes in the Consolidated Appropriations Act, 2023, the continuous coverage provision will end on March 31, 2023.

There is no limit on the amount of cash you can have with Medicare Part A. You do have to have paid taxes for 40 quarters (10 years) during your working lifetime and you have to be age 65 unless otherwise qualified due to a social security eligible disability.

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine foot care. Cosmetic surgery.

If you don't get premium-free Part A, you pay up to $505 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($174.70 in 2024).

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services.

MIAMI – Oct. 18, 2022 – Molina Healthcare of Florida (“Molina”) is the top-rated Medicaid plan in Florida, with a rating of 4 out of 5 stars in the National Committee for Quality Assurance's (NCQA) Medicaid Health Plan Ratings 2022.

Medicare does not cover custodial care, which is care that is not medically necessary, such as help with bathing, dressing, and eating. Medicare does not cover long-term care in a nursing home or assisted living facility unless you are also receiving skilled nursing care.