What Is the Difference between Medicare and Medicaid?

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06 Medicare Education Services -

Medicare and Medicaid are both government-run health insurance programs, so people often get them confused. 

Medicare

Medicare is a federal health insurance program that provides coverage for people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease,

Eligibility requirements for Medicare can differ, depending on the type of coverage desired. Generally, Medicare enrollment is possible for people who are:

  • 65 years old or older
  • Younger than 65 and who receive Social Security Disability benefits or have end-stage renal disease and meet other certain requirements
  • Have amyotrophic lateral sclerosis (Lou Gehrig’s Disease)

Medicaid

Medicaid is a joint federal and state program that helps pay for medical care for some low-income adults and children.

Because this program is state-run, eligibility requirements and benefits can vary widely.

In general, enrollees must not exceed set income guidelines — a percentage of the federal poverty level — to be eligible for Medicaid. There is no age requirement.

Citizenship and residency requirements apply to both programs.

It is possible for people to have both Medicare and Medicaid. But they must meet the qualifications of both programs.

People who have both Medicare and Medicaid are also often eligible for a special Medicare Advantage plan called a Dual Special Needs Plan. This plan enhances the benefits received under Medicare and Medicaid alone.

Resource for Those Needing More

Specific questions on government-run health insurance programs can be directed to Dave Morrison, licensed sales agent specializing in Medicare, at 484.424.5222 (TTY: 711) or submitted via the Medicare Education Services website.

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This video explains the Medicare/Medicaid difference in a more visual style, which can aid in understanding it.

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