Hougom Insurance Agency

Medicare 101

Medicare vs Medicaid

Medicare and Medicaid sound alike but are different programs. Medicare is federal health insurance mainly for people 65+ (and some with disabilities), regardless of income. Medicaid is a joint federal-state program for people with limited income and resources. If you qualify for both, you're 'dual-eligible' and may get extra help.

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Dual eligibility

People with both Medicare and Medicaid often qualify for a D-SNP plan with $0 premiums, very low costs, and extra benefits like grocery and OTC allowances. We can check your eligibility and enroll you.

Questions, answered

Can I have Medicare and Medicaid at the same time?

Yes — that's called being dual-eligible, and it usually unlocks lower costs and extra benefits through a D-SNP plan.

Is Medicare or Medicaid eligibility based on income?

Medicaid eligibility is based primarily on income and household size. Medicare eligibility is based mainly on age (65+) or specific disabilities — your income doesn't affect whether you qualify, though higher income can raise your Part B and Part D premiums through IRMAA.

Does Medicaid cover things Medicare doesn't?

Often yes — depending on your state's program, Medicaid can cover long-term custodial care, additional dental and vision benefits, and cost-sharing that Medicare leaves you to pay. That's a major reason dual-eligible status is valuable when you qualify.

Who administers Medicare vs. Medicaid?

Medicare is entirely federal, administered by CMS with the same rules nationwide. Medicaid is a joint federal-state program, so eligibility rules, covered services, and application processes vary by state — including Wisconsin's own Medicaid program.

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