Medicare vs. Medicaid: What Is the Difference?

Key takeaways

Medicare is federal health insurance mainly for people 65 or older. Medicaid is a joint federal and state program for people with limited income and resources.
Medicaid rules differ by state, and states run their own programs under federal requirements.
You can qualify for both programs and have both.
Medicaid can cover benefits Medicare does not normally cover, such as nursing home care.

The short answer

Medicare is federal health insurance for people 65 or older and for some younger people 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.

Side by side

Question	Medicare	Medicaid
Who it is for	People 65 or older, some people under 65 with disabilities, and people of any age with End-Stage Renal Disease.	Eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
What decides eligibility	Mainly age, certain disabilities or End-Stage Renal Disease.	Mainly income and family size. The rules differ by state.
Who runs it	The federal government.	States run it, following federal requirements. States and the federal government fund it jointly.
What it covers	Hospital insurance (Part A), medical insurance (Part B) and prescription drug coverage (Part D). Private Medicare Advantage plans are another option (Part C).	Benefits differ in each state. It can cover things Medicare does not normally cover, such as nursing home care and personal care services.
What it costs	Most people pay no premium for Part A. Most people pay a monthly premium for Part B and Part D.	Free or low-cost coverage.

Can you have both?

Yes. Some people qualify for both programs. Medicaid can help with benefits Medicare does not normally cover, such as nursing home care and personal care services.

Medicare in four parts

Part A (hospital insurance) helps cover inpatient hospital stays, skilled nursing facility care, hospice care and some home health care.
Part B (medical insurance) helps cover doctors' services and outpatient care.
Part C (Medicare Advantage) is a Medicare health plan offered by private companies that contract with Medicare. It provides your Part A and Part B benefits and often drug coverage.
Part D (prescription drug coverage) is available to everyone with Medicare through plans approved by Medicare.

Medicaid depends on your state

Each state runs its own Medicaid program under federal rules, so eligibility, benefits and costs can differ. Some states have expanded Medicaid to cover other adults below a certain income level. Medicaid.gov and HealthCare.gov explain how to apply in your state.

How to find out which one fits you

If you are 65 or close to it, review Medicare's enrollment rules. For most people, eligibility starts three months before turning 65 and ends three months after.
If your income is limited at any age, check your state's Medicaid eligibility.
If you are under 65 and do not qualify for either, compare plans on the Health Insurance Marketplace.

General information only. It is not insurance, legal or financial advice. Rules differ by state and change over time, so confirm details with your state insurance department, your insurer and your policy.

Common mistakes

Assuming Medicaid works the same way in every state.
Assuming you must choose one program when you qualify for both.
Missing your Medicare enrollment window, which for most people starts three months before turning 65 and ends three months after.

Questions

Is Medicaid the same in every state?

No. Each state runs its own program within federal rules, so eligibility and benefits can differ.

Does Medicare cover nursing home care?

Medicare Part A helps cover care in a skilled nursing facility, but not custodial or long-term care. Medicaid can cover nursing home care, and the details depend on your state.

Do I have to choose between Medicare and Medicaid?

No. If you qualify for both, you can have both.

Sources

HHS: Medicarehhs.gov
CMS: Medicare program, general informationcms.gov
Medicare.gov: Medicaidmedicare.gov
Medicaid.gov: Medicaidmedicaid.gov
HealthCare.gov: Medicaid and CHIP coveragehealthcare.gov
HHS: Who is eligible for Medicaid?hhs.gov

Informational only. Rules and policy terms change and differ by state and insurer. Confirm details with your policy, your insurer or your state insurance department.