Medicaid and Medicare

Medicare Vs. Medicaid

Medicaid is a joint federal and state program designed to provide free or low-cost health coverage to low-income people, families and children, pregnant women, the elderly, and people with disabilities. The federal government provides a portion of the funding for Medicaid and sets guidelines for the program. 

The state and federal governments share the cost of the Medicaid program. Medicaid plays a critical role in helping states and territories respond to public health emergencies and natural and human-made disasters. 

Medicare is a federal health insurance program designed for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).  Medicare has different parts that help cover specific services, including Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and Medicare Part D (Prescription Drug Coverage).

Medicaid

The Department of Elder Affairs partners with the Agency for Healthcare Administration to provide Medicaid Long-term Care options for elders. These services are designed to provide home care options for elders who qualify for Medicaid.

  • Program of All-Inclusive Care for the Elderly (PACE)

PACE provides primary care and social and supportive services for Medicaid and Medicare-eligible individuals 55 years of age and older for enrollees who live in a PACE service area. Read more about this program.

  • Statewide Medicaid Managed Care Long-term Care Program (SMMC LTC)

SMMC LTC is designed to provide non-medical services to Medicaid enrollees who are 65 years of age or older, or age 18 or older and eligible for Medicaid by reason of a disability. Read more about this program.

  • CARES

The CARES Program provides assistance to the Aging and Disability Resource Centers (ADRCs) to assess individuals for the Medicaid Long-Term Care program.  Read more about this program. Find your local ADRC and discuss how we can help you.   

Medicare

Serving Health Insurance Needs of Elders (SHINE)

SHINE is a program of the Florida Department of Elder Affairs and is operated locally through the eleven Aging and Disability Resource Centers. SHINE provides free, confidential, and unbiased Medicare counseling. SHINE is a part of the national State Health Insurance Assistance (SHIP) Program. Specially trained volunteers help Medicare beneficiaries, their families, and caregivers to understand their health care options.

SHINE also administers two other federal programs, the MIPPA (Medicare Improvements for Patients & Providers Act) Program and the SHINE/SMP Program. The SHINE/SMP (Senior Medicare Patrol) is a program to empower seniors to protect, detect, and report suspected Medicare Fraud. 

To receive help from SHINE, individuals may schedule appointments at designated SHINE counseling sites, attend enrollment events in their local communities, or arrange to speak with a trained SHINE counselor at 1-800-96-ELDER (1-800-963-5337). SHINE counseling sites and enrollment events are listed on their website.