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Are Medicare and Medicaid the Same Thing?

In 2020, over 297 million people had health insurance in the US. This number is a drastic increase from the previous decades. 

However, over 30 million people are still without essential health benefits, making up nearly 10% of the country.

Since 1965, both Medicare and Medicaid have helped retirees and low-income families get the covered services to pay health care costs.

Because these services have similar names, many people confuse them. In short, Medicare is for adults 65 and older and for those with specific disabilities. 

When can I first enroll in Medicare infographic showing timeline with "3 months before" and "3 months after" 65th birthday, highlighting Initial Enrollment Period for Medicare eligibility.

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Medicaid is for anyone who qualifies. Although adults 65 and older can use both plans if eligible, someone on Medicaid cannot necessarily use Medicare.

Since these two programs are different, when should you look into each one?

Everything You Need to Know About Medicare

When you join Medicare, there are four options available within the program. Understanding these four parts of the program is the best way to get the most out of your medical coverage.

Part ARequired under Social SecurityHospital insurancePay deductibles and coinsurance
Part BRequired under Social SecurityMedical insurance for services and equipmentDoctors visitsOutpatient care
Part CMany people who qualify for Parts A and B can sign up for Part C if they want.HearingVisionDentalPrescription drugsPay out-of-pocket
Part DPrescription drug coveragePay out-of-pocketDeductiblesYearly copaymentsAvailable for those who don’t qualify for Part C’s prescription drug coverage

Essential Information About Medicaid

Medicaid services are an option for those who need the federal government and state-run health coverage but are below 65 years of age.

Since there is no age restriction on Medicaid eligibility, many people qualify who don’t already have insurance if they fall under the income threshold.

There are a few types of people who may qualify for Medicaid programs:

  • Adults over 65 who need additional coverage to their Medicare plan
  • Adults under 65 who fall under the income threshold and meet the qualifications for their state.
  • Children who do not have any health coverage (children’s health insurance program).
Table illustrating eligibility criteria for Children's Medicaid, showing family members, monthly income, and yearly income thresholds.

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Qualification for Medicaid coverage varies by state, but the type of coverage also varies. Medicaid is a federal and state-run program, which is why there are variations depending on your location.

Make sure you check the qualifications for your state. Depending on your location, you might receive coverage for the following:

  • Hospitalization
  • Laboratory services
  • X-rays
  • Doctor services
  • Family planning
  • Nursing services
  • Nursing facility services
  • Home healthcare for people eligible for nursing facility services
  • Clinic treatment
  • Pediatric and family nurse practitioner services
  • Midwife services

One of the most significant differences between Medicare and Medicaid is that the latter provides nursing home and personal care services, which Medicare doesn’t typically cover.

Which One is Best for You?

If you are of retirement age, you more than likely qualify for Medicare. One of the great things about Medicare is that you can pair it with Medicaid if you qualify in your state.

In other words, you don’t have to worry about a lack of coverage when you retire. Contact your local state office or visit their website to learn more.