Social Security and You: Medicare, Medicaid and Social Security

Tom Margenau on Mar 27, 2024

I can't tell you how many times over the years (tens of thousands of times) people have told me something like this: "Yes, I have both parts of Medicare. I have Medicare and Medicaid." But what they meant to say was: "I have both parts of Medicare. I have Part A and Part B." That's just one example of the many ways people confuse Medicare and Medicaid.

Before I move on to a brief overview of Medicaid, I must point out that there are other parts to Medicare such as Part C (usually called Medicare Advantage Plans) and Part D, which offers prescription drug coverage. I know almost nothing about these programs, so I'm not explaining them here. I'm simply acknowledging that they exist.

So now on to Medicaid. What is it? In some past columns, I almost flippantly and offhandedly have told readers that Medicaid is like Medicare, but for poor people. And that is sort of correct, but of course there is so much more to it than that.

Briefly, Medicaid is a joint federal and state program that covers medical costs for people with limited income and resources. Because there is that state tie-in, the eligibility rules can vary from one state to another. So there is simply no way I can explain them in a nationally syndicated newspaper column. Suffice it to say, you've got to be pretty darn poor to get Medicaid coverage. In fact, I'm betting that most readers of this column are getting Medicare, but very few of them are getting Medicaid.

I just said there are state-specific eligibility rules for Medicaid. But there is one national program that includes Medicaid eligibility. And that's the Supplemental Security Income program. SSI is a federal welfare program that pays a small monthly stipend (rarely more than about $900 per month) to elderly poor and to poor people with disabilities. And Medicaid eligibility almost always goes along with an SSI check. And another one of the jurisdictional problems is that SSI is managed by the Social Security Administration. And that leads people to think that their Medicaid coverage comes from the SSA. But again, it doesn't. Once the SSA gets you on SSI, then a state social service agency (i.e., welfare office) takes over your Medicaid coverage.

So that's a very brief overview of these often-confused programs.

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If you have a Social Security question, Tom Margenau has two books with all the answers. One is called "Social Security -- Simple and Smart: 10 Easy-to-Understand Fact Sheets That Will Answer All Your Questions About Social Security." The other is "Social Security: 100 Myths and 100 Facts." You can find the books at Amazon.com or other book outlets. Or you can send him an email at thomas.margenau@comcast.net. To find out more about Tom Margenau and to read past columns and see features from other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.