What’s the difference between Medicare and Medicaid? (2024)

FAQs

What’s the difference between Medicare and Medicaid? ›

Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.

Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.

Medicare provides health care for older people, while Medicaid provides health care for people with low incomes.

Answer and Explanation:

Medicare is sponsored solely by the federal government. Medicaid is funded by both the state and federal governments.

Medicare is federally funded health insurance for people who are aged 65 or older, some younger people with disabilities, and people with end-stage renal disease. Medicaid provides health care coverage for eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine foot care. Cosmetic surgery.

Medicare doesn't typically cover 100% of your medical costs. Like most health insurance, Medicare generally comes with out-of-pocket costs including copayments, coinsurance, and deductibles. As you'll learn in this article, Original Medicare (Part A and Part B) costs can really add up.

Medicaid and Original Medicare both cover hospital stays and doctor visits. But Medicaid's coverage is usually better because it automatically covers prescription drugs and long-term care. States can choose to cover more, too, like dental care for adults.

Medicare provides health care for older people, while Medicaid provides health care for people with low incomes. It developed gradually through legal precedents and Supreme Court rulings.

Medicare-Medicaid enrollees include people ages 65 and over who are in relatively good health but have limited financial resources and people who at one time, may have had more financial resources, but spent their income and wealth on health or long-term care costs.

Who is not eligible for Medicare? ›

Did not work in employment covered by Social Security/Medicare. Do not have 40 quarters in Social Security/Medicare-covered employment. Do not qualify through the work history of a current, former, or deceased spouse.

Medicaid is a joint federal and state program that helps cover medical costs for people with limited income and resources. It offers benefits not normally covered by Medicare, like nursing home care and personal care services.

The Bottom Line. Medicare and Medicaid are both government-run programs that cover health care costs. Medicare is open to Americans age 65 or older or who meet certain criteria, while Medicaid is designed for low-income Americans of any age, but with strict income requirements that vary by state.

Medicare Advantage: Coverage. Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).

Are Medi-Cal and Medicare the same? No, Medi-Cal is health coverage offered by the state of California, and Medicare is a national health coverage program. The primary difference between these two programs lies in their objectives, eligibility criteria, and types of benefits offered.

$0 for most people (because they or a spouse paid Medicare taxes long enough while working - generally at least 10 years). If you get Medicare earlier than age 65, you won't pay a Part A premium. This is sometimes called “premium-free Part A.”