In the United States, residents can participate in two government-provided health insurance policies: Medicare and Medicaid. While they both provide public health insurance benefits, there are significant differences in eligibility and coverage that must be identified and understood.

The most crucial difference is that Medicare is available to adults over 65, whereas Medicaid is only available to low-income families.
Medicaid is typically less expensive than Medicare, offering free or low-cost coverage to those close to or below the poverty line. On the other hand, Medicare is available to people of all income levels and often costs a few hundred dollars a month.
Differences between Medicare and Medicaid
Medicare and Medicaid are health insurance programs available to citizens and permanent residents of the United States. There are, however, two significant distinctions between the two programs: coverage and the types of services that are eligible for reimbursement.
Coverage
Medicaid, in general, is a complete health insurance policy, with a single plan covering medical, hospitalization, and prescription drug needs. Medicaid also covers adult dentistry and vision in several states.
In contrast, Medicare is divided into numerous components, each providing a different coverage level. Original Medicare, which comprises Parts A and B, contains various coverage gaps that can be covered by purchasing additional Medicare plans such as Part D or Medicare Advantage.
The most prominent coverage distinction between Original Medicare and Medicaid is that only Medicaid covers long-term care facilities such as nursing homes.
What is Medicare?
Medicare is provided to Americans over the age of 65 and those under the age of 65 who have been diagnosed with a disability or sickness.
Lou Gehrig’s disease (ALS) and end-stage renal failure are qualifying medical conditions (ESRD).
It is essential to know that your income does not determine Medicare eligibility. Most Americans would have contributed to the Social Security fund during their working years.
You can participate in the Medicare plan when you reach age 65 by contributing to this pool of tax monies. This, however, would only enroll you in Medicare Part A, which covers hospital treatment and nothing else. As a result, you would need to choose and purchase one of the many other aspects of Medicare to have a complete plan.
Original Medicare
Individuals who desire Original Medicare will typically enroll in Part A and then have the option of purchasing Parts B and D for a reasonable monthly payment. Because there are penalties for late enrollment, most people choose to buy.
Part B covers doctors, medical tests, and some treatments, whereas Part D is intended to cover the price of prescription drugs.
Enrolling in Medicare Parts B and D brings a person closer to having a comprehensive health insurance policy.
Medicare Advantage
Medicare Advantage, often known as Part C, is a current health insurance program that combines all aspects of Original Medicare.
Plans determine their deductibles and out-of-pocket maximums, and they typically include other benefits such as dentistry, hearing, and prescription medicines. When comparing Medicaid and Medicare, it is vital to realize that Medicare Advantage coverage is supplied by commercial health insurance firms such as UnitedHealthcare and Aetna rather than the government. This allows you to compare policies from several providers and select the best Medicare Advantage policy for your specific scenario.
What is Medicaid?
Medicaid is a federal and state-run health insurance program for low-income Americans. To be eligible for Medicaid coverage, you must have an income below the state’s criterion. In states with expanded Medicaid is 138 percent of the federal poverty line.
Individuals earning less than $18,754 or families earning less than $38,295 can qualify for Medicaid in these states. Income eligibility standards differ by state and situation, such as disability or pregnancy.
Use the income calculator at Healthcare.gov to see if you satisfy the qualifying requirements in your state. You can enter your anticipated income and see if you qualify based on the number of people in your family. As you can see, as the number of dependents in your family grows, so does the income threshold for Medicaid.
Can both Medicare and Medicaid cover me?
It is possible to qualify for and get Medicare and Medicaid coverage.
The term “dual eligible” in health care describes this situation. These people are often enrolled in Original Medicare but receive subsidized Medicaid benefits through Medicare Savings Programs such as:
Qualified Medicare Beneficiary (QMB) Program Specified Low-Income Medicare Beneficiary (SLMB) Program Qualified Disabled and Working Individual (QDWI) Program Qualified Disabled and Working Individual (QDWI) Program
These schemes would assist with Medicare premiums, deductibles, and coinsurance. If you do not qualify for Medicaid while enrolling in Medicare, there are still opportunities for financial assistance with Part A, B, and D deductibles.
One example is enrolling in supplemental Medigap coverage, such as Medicare Part F, which commercial health insurance firms offer.
Frequently asked questions
What’s the distinction between Medicare and Medicaid? Medicare and Medicaid cover separate categories of individuals: Medicaid is for people with low incomes, such as those earning less than $18,754 per year, and Medicare is for persons over the age of 65 and those with disabilities. If you match the eligibility requirements for both programs, you can be enrolled in both Medicare and Medicaid.
How do you become eligible for both Medicare and Medicaid?
To be eligible for both Medicare and Medicaid, you must meet the income requirements of your state’s Medicaid program as well as the Medicare eligibility requirements of being 65 or older or having a qualifying handicap.
What is the difference between Medicaid and Medicare coverage?
Hospitalizations, doctors, and medical care are covered under Medicaid and Original Medicare. However, Medicaid coverage is typically more complete, including prescription medicines, long-term care, and other state-determined add-ons such as adult dental care. In contrast, Medicare entails merging several sections. Thus, your benefits will be determined by the commercial Medicare plans you add on top of your Original Medicare.
How many people are covered by Medicaid versus Medicare?
Medicare has 64 million people enrolled. Medicaid and CHIP, or the Children’s Health Insurance Program, cover 87 million individuals. Approximately 19% of all Medicare enrollees are simultaneously enrolled in Medicaid.