It is common to have questions about different health insurance coverage types, particularly the differences between Medicare and MassHealth. Here in Massachusetts, MassHealth is just the state name for Medicaid, and it is no different than the Medicaid care offered in other states. An easy way to quickly differentiate these two types of coverage is to think of Medicare as care for the elderly, while Medicaid is aid for those who can’t afford coverage. These two types of care can have significant differences, and one is likely more appropriate than the other in certain situations.

What Is MassHealth/Medicaid?

Stethoscope in doctors desk

Medicaid offers a variety of coverage to participants based on several factors such as income, age, and if the participant has a disability. The MassHealth standard level of coverage is the most comprehensive coverage and includes services like inpatient hospital stays, outpatient appointments, mental health care, pharmacy costs, and lab tests or X-rays. It also covers long-term care services, hospice, and care for chronic diseases or rehabilitation after an injury. Proper Medicaid planning can help eligible participants get the right level of coverage and care for every stage in life.

What Is Medicare?

Unlike MassHealth, which is a state-organized program, Medicare is a federal health insurance program specifically for senior citizens that is broken out into several different parts. For example, Medicare Part A covers inpatient hospital visits as well as in-home health care, hospice care, and costs associated with a skilled nursing home facility. Part B covers outpatient care, Part C is a private health plan through Medicare, and Part D covers prescription drug costs. In addition, some patients who receive Medicare may also be eligible for MassHealth coverage to help pay for expenses from Part A or B premiums and non-pharmacy copayments and deductibles.

Talk to a Professional

While this offers a brief introduction to these two types of coverage, these are complex systems with many rules and regulations that may affect your coverage. If you are nearing the age of 65 or have aging parents, we recommend you speak with a professional about your coverage options. At The Law Office of Arthur P. Skarmeas, LLC, our elder law attorneys can help you plan for your future and make an empowered decision about your health coverage. Contact our office in Topsfield, MA today to schedule your free consultation.

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