The short answer
Medicare and Medicaid are both government health programs, but they serve different purposes. Medicare is a federal program primarily for people 65 and older, and some younger people with disabilities, regardless of income. Medicaid is a joint federal-state program for people with limited income and resources, of any age. The simplest way to remember it: Medicare is based mainly on age, while Medicaid is based mainly on income. Some people qualify for both, and the two programs then work together.
So Medicare is age-based coverage while Medicaid is income-based, and the two serve different needs though some people have both.
How they differ
Medicare has standard parts, premiums, and cost-sharing that apply nationwide, while Medicaid rules and benefits vary by state and generally cost enrollees little or nothing. Medicaid also covers some things Medicare does not, notably long-term custodial care for those who qualify. People who have both Medicare and Medicaid are called dual-eligibles, and Medicaid can help pay Medicare's premiums and cost-sharing. Our guide to applying for Medicare and Medicaid covers enrollment in each.
The core differences are eligibility basis, cost, state variation, and Medicaid's coverage of long-term care.
Who qualifies for both
People with limited income who are also 65 or older, or who have a qualifying disability, may be eligible for both Medicare and Medicaid. For them, Medicare is the primary payer and Medicaid helps with costs Medicare leaves, which can make coverage very affordable. If you think you might qualify for help, it is worth checking. Our government help center points to resources. This is educational information; confirm eligibility with the official programs.
The takeaway: Medicare is age-based and Medicaid is income-based, they cover different gaps, and low-income seniors may qualify for both with Medicaid helping pay Medicare's costs.
Frequently Asked Questions
What is the difference between Medicare and Medicaid?
Medicare is a federal program mainly for people 65 and older regardless of income; Medicaid is a joint federal-state program for people with limited income and resources of any age. Medicare is age-based, Medicaid income-based.
Can I have both Medicare and Medicaid?
Yes. People with limited income who are 65 or older or have a qualifying disability may be dual-eligible. Medicare pays first and Medicaid helps with premiums and cost-sharing, making coverage very affordable.
Does Medicaid cover long-term care?
Medicaid covers long-term custodial care for those who qualify, which Medicare generally does not. This is one of the key differences between the two programs.
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