Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It primarily serves individuals over the age of 65. Medicaid is an assistance program. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses.
Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.
The following resources are available to help IDA members navigate Medicaid compliance, patient eligibility, claims processing and more:
- Medicaid Helpful Hints – information compiled by Dr. Leila Alter to help fellow members navigate IHCP programs and administration
- CoreMMIS Updates – information to help members stay up to date on the new portal
- Medicaid Resources – listing of links and state information pertaining to Indiana Medicaid
- Indiana Medicaid for Providers – the State’s website dedicated to Indiana Medicaid providers
- Medicaid FAQ – frequently asked questions regarding Medicaid
- IHCP Patient Waiver – to be used when billing an IHCP patient for noncovered services
- Medicaid Cheat Sheet – extensive compilation of Medicaid contact information
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Very few dental services are covered by Medicare, but recent and upcoming changes have impacted dentists. The following resources are available for IDA members:
- Medicare Enrollment FAQ – information on opting in or opting out of Medicare
- The ADA offers its own resources on Medicare on the Center for Professional Success website, Success.ADA.org/en/practice/medicare. It includes information on how dentists can opt in or out of Medicare and frequently asked questions about the program.
To read ADA News coverage on opting in or out of Medicare, visit ADA.org/adanews and search for “ADA Offers Q&A Primer on Opting In or Out of Medicare” and “Dentists Must Choose to Opt In or Out of Medicare Enrollment.”