SSI vs. Medicare: How Do These Programs Compare?

Medicare is a federal program that provides free or reduced-cost health insurance coverage to qualifying individuals. Medicare health insurance eligibility requirements include factors like age, health, or ability. The nationwide program has four parts, each of which provides a different type or level of coverage.

Supplemental Security Income (SSI) is also a federal program that helps aged, disabled, and low-income people. It provides for beneficiaries’ basic needs but works differently than Medicare. Learn about the differences between programs and how they relate.

What is Medicare and How Does It Work?
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The federal government established Medicare to financially assist seniors and those with disabilities or certain medical conditions. Beneficiaries have access to affordable health care insurance and, therefore, more medical options.

You qualify for Medicare if you are 65 years of age or older. You may be eligible for enrollment into the program if you are younger than 65 years of age and have a qualifying disability or permanent renal disease.

For SSI benefits, you must be 65 years of age or older, blind or disabled, and have limited income or resources. You must also:

  • Be a U.S. citizen, national, or a specific category of alien.
  • Be a resident of one of the 50 states, D.C. or the Northern Mariana Islands.
  • Not be absent from the country for more than 30 consecutive days.
  • Not be confined to an institution, such as jail or a hospital.

Medicare has four parts; A, B, C, and D. Original Medicare is Part A and B together. Part A covers hospital expenses, and Medicare Part B covers medical services. Medicare Part D only covers prescription drugs.

Part C – Medicare Advantage – combines Parts A, B, and C into a single insurance, often under a third-party insurer. Part C works the same way employer-based coverage works. If you had insurance through your job, for example, your coverage and even the provider would work similarly to your Medicare Part C insurance.

Each Part will have different costs when it comes to premiums, deductibles, and coinsurance. Since the government handles Parts A, B, and D while private companies provide Part C plans, how they work and the covered services differ. You should enroll in the plan or plans that best work for your budget and medical needs. 

Whichever plan you choose, you are not stuck with, as you can make plan changes during certain periods or after specific events. 

You will need to enroll in Medicare during a certain period after you become eligible, or you could face late enrollment penalties. This period is your Initial Enrollment Period, and it is seven months long. 

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