Medicare and Medicaid are both taxpayer funded social government programs established in 1965 that help people pay for healthcare. Despite sounding similar, they are very different programs. Follow along to understand how Medicare and Medicaid work so you can better understand the differences between them.

What is the difference between Medicare and Medicaid?

The main differences between Medicare and Medicaid come down to how each program is funded and who the programs serve.

  • Medicare is a federal health insurance program that serves people 65 years of age or older and certain younger people with disabilities and end-stage renal disease (ESRD).
  • Medicaid is both a federal and state funded assistance program that helps low-income people of every age with healthcare costs.

Who qualifies for Medicaid and Medicare?

In general, most people turning 65 are eligible for premium-free Medicare Part A based on taxes they paid while working, and can choose if they want to enroll in Part B. Some people under the age of 65 with certain disabilities may qualify for Medicare after they’ve been disabled for 24 months.

Medicaid, on the other hand, helps with medical costs for people of any age with limited income and resources. However, there are additional eligibility requirements.

Who can get Medicare? Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) are available to U.S. citizens or permanent legal residents of at least five continuous years who are age 65 or older, as well as some younger individuals who are disabled or have End-Stage Renal Disease (ESRD).

You are eligible at age 65 and older if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board; usually after having earned 40 credits from about 10 years of work.
  • You are eligible to receive Social Security or Railroad benefits, but you have not filed for them yet.
  • You or your spouse had Medicare-covered government employment.

Learn more about eligibility for Medicare Part A and Medicare Part B.

Who can get Medicaid? Medicaid can cover qualified low-income people, including families and children, pregnant women, the blind, seniors, people with disabilities, and other people who are eligible to receive federally assisted income maintenance payments.  The state you live in and the size of your household determine eligibility. In some states the program covers all low-income adults below a certain income level. Eligibility requirements vary by state and can be found on the Medicaid website.

Can you have both Medicaid and Medicare?

Low-income Medicare beneficiaries can receive Medicare benefits and Medicaid at the same time. The Medicare and Medicaid programs work together to provide healthcare coverage to Medicare recipients who meet the low-income qualifications for Medicaid. However, individuals receiving Medicaid who do not meet Medicare’s eligibility requirements are not entitled to both benefits.

Looking for Medicare coverage? We offer free, accurate comparisons for Medicare Advantage (Part C), Medicare Supplement (Medigap), and Medicare Prescription Drug (Part D) Plans.

Get an online quote for Medicare plans that fit your healthcare needs today! Or call 1-877-388-0596 – TTY 711 to get answers and guidance over the phone from an experienced licensed sales agent.

Related Information:

What Is Medicare Advantage? 

Does Medicare Pay for Prescription Drugs?

The Pros of Using a Medicare Agent to Find a Plan