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Medicare 101

Is Obamacare the Same as Medicare?

Medicare and Obamacare are different things, but both affect the health care of millions of Americans. Learn more about the differences between them.

Christian Worstell

by Christian Worstell | Published October 31, 2023 | Reviewed by John Krahnert

Medicare and The Affordable Care Act (also known as Obamacare) affect health insurance coverage for millions of Americans in very different ways. Medicare is a federal health insurance program for Americans over age 65 and certain people under age 65 who have qualifying conditions or disabilities. "Obamacare" is a nickname for the Patient Protection and Affordable Care Act of 2010 (also known as the ACA).

Learn more about the basics of Obamacare vs. Medicare, including the main differences between the two and how they affect you.

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What Is Medicare?

Medicare was first created in 1965 and now provides health coverage to more than 66 million Americans

Medicare Part A and Part B (Original Medicare) pay for some of the costs associated with hospital and physician services.

  • Medicare Part A covers hospital services, including inpatient hospital stays, care in a skilled nursing facility and some home health services.

  • Medicare Part B covers doctor’s services, including doctor visits, surgeries, lab tests and medical supplies (like wheelchairs and walkers).

Original Medicare requires some out-of-pocket costs, including deductibles, copayments, coinsurance and other fees. Many Medicare beneficiaries purchase a Medicare Supplement Insurance plan (also called Medigap) to help cover some of these costs. Medigap plans are sold by private insurance companies, but their basic benefits are standardized by the federal government.

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What Is Obamacare?

Obamacare's primary intention is to give all Americans the ability to purchase affordable health insurance. There are several different parts to the law that each affected a different aspect of health insurance access.  Here are some of the more well-known:

  • Individual Mandate
    One of the most-talked-about aspects of the ACA was its provision stating that everyone is required to have health insurance. Those who do not have health insurance face a tax penalty.

  • Coverage of Pre-Existing Conditions
    Another one of the biggest changes ACA made was to prohibit insurance companies from denying someone coverage or charging them more because of a pre-existing condition. And because as many as 1 in 2 Americans have some type of pre-existing condition, this provision has been one of the law’s more popular.

  • Health Insurance Subsidies
    Under Obamacare, people who qualify for financial assistance are eligible for health insurance tax credits to help offset the cost of their insurance.

  • Exchanges
    Exchanges, or online marketplaces for health insurance, are how people are supposed to purchase affordable insurance policies under the ACA. Private health insurance companies offer policies in the marketplace and compete for the business of shoppers. Any legal citizen can purchase insurance from the exchanges, but not everyone qualifies for the low-income subsidies.

The Obamacare Health Insurance Exchange Marketplace first opened in 2013, and by 2023 more than 16 million people annually were using the exchange to enroll in coverage.

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Medicare vs Obamacare

Medicare is insurance provided by the federal government for people over the age of 65 and the disabled, and Obamacare is a set of laws governing people’s access to health insurance. There is no one type of policy that is considered “Obamacare.” Under Obamacare, private insurance companies compete for business by offering affordable plans with different levels of coverage. Unlike Obamacare, coverage under Original Medicare is provided specifically by the federal government.

Only people aged 65 and up and certain younger people with qualifying disabilities (like End-Stage Renal Disease) are eligible to be on Medicare. Unlike Medicare, any U.S. citizen buying his or her own health insurance is eligible to purchase a plan off of one of the exchanges set up by Obamacare.

Obamacare vs Medicaid

Medicaid is similar to Medicare but is designed for people of lower income levels. Unlike Medicare, qualifying criteria for Medicaid varies by state. 

Is Medicare the Same as ACA?

No, Medicare is not the same thing as the ACA. Obamacare and the Affordable Care Act govern what private insurance companies cover and how much they can charge.

Learn more about Obamacare and how it affects both Medicare and Medigap insurance plans.

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1-800-995-4219

 

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