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When choosing a health insurance plan, you should consider all your options. You’ll want to check if you qualify for government-run programs like Medicare and Medicaid based on age, income, and disability status. Even if you qualify for one of these programs, you could still choose a private insurance plan from the insurance marketplace.
It’s important to note that Aflac does not offer primary health insurance. However, we offer supplemental insurance that works alongside your existing plan to help offset gaps in coverage, whether you have Medicare, Medicaid, or a private plan..
We have various targeted plans that can help provide financial relief in distinct categories. For example, our hospital insurance helps pay for the costs associated with a trip to the emergency room. In contrast, our critical illness insurance helps cover whatever you need after a covered life-changing illness, like a heart attack or stroke.
Read on to learn how Medicare and Medicaid work and what they cover, the differences between them, and how these plans compare to private health insurance.
It’s not uncommon to wonder what the difference is between Medicare and Medicaid. Medicare is a federal government-run program that provides health insurance to those who have a disability or are over 65 years old. There are no income requirements for Medicare.1
On the other hand, Medicaid is a government and state-run program that helps provide insurance to those with low income.1 The income requirements vary from state to state, so we recommend researching the state you live in and Medicaid guidelines.
In some cases, you may qualify for both Medicare and Medicaid. You are able to use both at the same time. When both Medicare and Medicaid work together, you’re more likely to receive better coverage and have fewer out-of-pocket costs.1
Don’t wait until it’s too late. Help cover yourself and your family with affordable coverage from Aflac.
Here are some key differences between Medicare, Medicaid, and private health insurance plans:
Even if you qualify for Medicare, you may want to assess all your health insurance options. For example, if you are over 65 but haven’t retired, you may still get private insurance options from your employer. Your employer-provided plan may offer better coverage than Medicare.
If you aren’t getting insurance through your employer, you can still shop for private insurance through the insurance marketplace. When shopping for a plan, you’ll want to consider how much the monthly payments are (premiums), what out-of-pocket costs will look like after insurance is used, and what all is covered. Looking at each insurance plan carefully is helpful during this part of the process.2
When choosing between Medicare and a private health insurance plan, it depends on what your priorities are. You’ll want to compare the costs and benefits of the private insurance plans you are considering and Medicare. For your reference, Medicare monthly premiums can cost up to $170.2 On the other hand, the average cost of private health insurance for individuals is $456 per month.2
You’ll also want to consider the network of doctors you can choose from in a private health insurance plan vs. Medicare. With Medicare, you can go to any doctor who accepts the National program—and many doctors do.2 You may have more options within a private health insurance plan, but it depends on which one you are considering and how it functions. The specific coverage offered varies from plan to plan, so we recommend looking at each insurance option with a close eye.
Price is usually the main determinant when comparing Medicaid and private health insurance. Since Medicaid is offered to those with low income, the cost of private health insurance can sometimes be more expensive.
Medicaid exists to help provide insurance to those who cannot afford it, and it fulfills a necessary role in the healthcare system. In fact, around 70 million Americans used Medicaid coverage in 2020.4 On the other hand, you may receive better coverage options through a private health insurance company.4 Which insurance option you choose ultimately depends on the coverage and cost of the private health insurance plan you are considering.
Medicare and Medicaid are both types of health insurance that can offer great coverage and help lower your out-of-pocket costs. Now that you understand the differences between Medicare and Medicaid and your options regarding private health insurance, you may have a better idea of what your next steps look like. Regardless of your chosen plan, some medical expenses may not be covered by insurance. Aflac supplemental insurance works with your existing plan to help offset those costs.
We provide supplemental cancer, hospital, critical illness, vision, accident, short-term disability, and dental insurance. Chat with an agent to discover how our insurance plans can easily fit your budget.
1 Medicare Interactive - Differences between Medicare and Medicaid. Accessed February 19, 2024. https://www.medicareinteractive.org/get-answers/medicare-basics/medicare-coverage-overview/differences-between-medicare-and-medicaid.
2 EHealth -How Much Does Individual Health Insurance Cost. - How Much Does Individual Health Insurance Cost. Updated December 7, 2023. Accessed February 19, 2024. https://www.ehealthinsurance.com/resources/individual-and-family/how-much-does-individual-health-insurance-cost.
3 Health Markets - Medicare vs. Private Health Insurance. Updated October 13, 2023. Accessed February 19, 2024. https://www.healthmarkets.com/resources/medicare/medicare-vs-private-health-insurance/.
4 Help Advisor - Medicaid vs. Private Insurance. Updated April 17, 2023. Accessed February 19, 2024.https://www.helpadvisor.com/medicaid/medicaid-vs-private-insurance.
Coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, coverage is underwritten by American Family Life Assurance Company of New York. Cancer/Specified-Disease: In Delaware, Policies B70100DE, B70200DE & B70300DE. Policy A72200. In Idaho, Policies B70100ID, B70200ID, B70300ID, B7010EPID, B7020EPID. Policy A72200ID. In Oklahoma, Policies B70100OK, B70200OK, B70300OK, B7010EPOK, B7020EPOK. Policy A72200OK. In Virginia, policies A75100VA–A75300VA. Accident: In Delaware, Policies A36100DE—A36400DE, & A363OFDE. Policy A371AA & A371BA. In Idaho, Policies A36100ID–A36400ID, & A363OFID. Policy A37000ID. In Oklahoma, Policies A36100OK– A36400OK, & A363OFOK. Policy A37000OK. In Virginia, Policies A36100VA – A36400VA, & A363OFVA. Policies A371AAVA & A371BAVA. Hospital: In Idaho, Policies B40100ID & B4010HID. In Virginia, Policies B40100VA & B4010HVA. Critical Illness: In Delaware, Policies A74100DE, A74200DE, A74300DE. Policies B71100, B71200, B7130H & B7140H. Policies A71100DE & A71200DE. In Idaho, Policies A74100ID, A74200ID, A74300ID. In Oklahoma, Policies A74100OK, A74200OK, A74300OK. Policies A73100OK & A7310HOK. Policies B71100OK & B7110HOK. Policies A71100OK & A71200OK. In Virginia, Policies A74100VA, A74200VA, A74300VA. Policy A73100VA. Policies A71100VA & A71200VA. Vision: In Delaware, Policy VSN100. In Idaho, Policy VSN100ID. In Oklahoma, Policy VSN100OKR. In Virginia, Policy VSN100VA. Short-term disability: In Delaware, Policies A57600DE & A57600LB. In Idaho, Policy A57600IDR. In Oklahoma, Policies A57600OK & A57600LBOK. In Virginia, Policies A57600VA & A57600LBVA. Dental: In Delaware, Policies A81100–A81400. Policies A82100R–A82400R. In Idaho, Policies A81100ID–A81400ID. Policies A82100RID–A82400RID.In Oklahoma, Policies A81100OK–A81400OK. Policies A82100ROK–A82400ROK. In Virginia, Policies A81100VA–A81200VA. Policies A82100RVA–A82400RVA.
Coverage underwritten by Tier One Insurance Company, a subsidiary of Aflac Incorporated and is administered by Aetna Life Insurance Company. Tier One Insurance Company is part of the Aflac family of insurers. In California, Tier One Insurance Company does business as Tier One Life Insurance Company (Tier One NAIC 92908). Accident: In Delaware, Policy T37000. In Idaho, Policies T37100IDR, T37200IDR, & T37300IDR. In Oklahoma, Policy T37000OK. Cancer/Specified-Disease: In Delaware, Policy T70000. In Idaho, Policy T70000ID. In Oklahoma, Policy T70000OK. In Virginia, policies T70000VA & T70000GVA. Critical Illness: In Delaware, Policy T71000. In Oklahoma, Policy T71000OK. In Virginia, Policy T71100VA. DVH: In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. Final Expense Life: In Arkansas, Delaware, Idaho, Oklahoma, Oregon, Pennsylvania, Texas, & Virginia, Policies ICC21-AFLLBL21 and ICC21-AFLRPL21; and Riders ICC21-AFLABR22, ICC21-AFLADB22, and ICC21-AFLCDR22.
Pet - Trupanion policies are sold and administered by Trupanion Managers USA, Inc. (“TMUI”) (licenses available here), and are underwritten by American Pet Insurance Company (“APIC”), with its main office at 6100 4th Ave S, Seattle, WA 98102. Aflac Benefits Advisors, Inc. (d/b/a Aflac Insurance Solutions), a subsidiary of Aflac Incorporated and a licensed insurance producer (NPN 16512385) (California License #0H86831), has limited authority to advertise Trupanion policies, does not intend to sell, solicit, or negotiate policies on behalf of APIC, does not have authority to bind coverage on behalf of APIC, and may receive compensation from TMUI for insurance policies sold by TMUI further to a referral from Aflac Benefits Advisors, Inc. Aflac Benefits Advisors, Inc. does not have authority to sell, solicit, or negotiate insurance policies in Puerto Rico. TMUI, APIC, and their affiliates are separate, independent of, and distinct from Aflac Benefits Advisors, Inc. Terms and conditions including limitations and exclusions apply. Availability and qualification for coverage, terms, rates and discounts may vary by jurisdiction. See the full policy for details. Information you provide to TMUI is subject to Trupanion’s privacy policy and website terms of use, and may be shared with Aflac Benefits Advisors, Inc.
This is a brief product overview only. Coverage may not be available in all states including but not limited to Delaware, Idaho, New Jersey, New Mexico, New York or Virginia. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. The policies have limitations and exclusions that may affect benefits payable. Refer to the exact policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Aflac agent. Content within this article is provided for general informational purposes and is not provided as tax, legal, health, or financial advice for any person or for any specific situation. Employers, employees, and other individuals should contact their own advisers about their situations. For complete details, including availability and costs of Aflac insurance, please contact your local Aflac agent.
Aflac WWHQ | Tier One Insurance Company | 1932 Wynnton Road | Columbus, GA 31999
NY | 22 Corporate Woods Boulevard, Suite 2 | Albany, NY 12211
Z2400158
EXP 6/25
