Is Medicaid the Same Thing as Medicare?

If you’ve ever mixed up Medicaid and Medicare, you’re in good company. The names sound nearly identical, both programs help with health care costs, and they’re both run (at least in part) by the government. But Medicaid and Medicare are not the same thing. In fact, they serve different groups of people, have different rules, and pay for different kinds of care.

The confusion is understandable. Medicaid is based mostly on income and need, while Medicare is based mostly on age or disability. Some people even qualify for both programs at the same time, which adds to the overlap.

Let’s break it down step by step so you can see how these two programs compare.

Want to keep up with guides like this? Sign up for BenefitKarma and stay in the know on benefits that affect your health, family, and finances.

Key Takeaways:

• Medicaid and Medicare are not the same; one is income-based, the other is age/disability-based.

• Medicare is federal; Medicaid varies by state.

• Costs and coverage differ, but both help millions of Americans access health care.

• Some people can be covered by both at the same time.

What is Medicare?

Medicare is a federal health insurance program. That means it’s the same in every state. You qualify if you are:

• Age 65 or older, or

• Younger than 65 with a qualifying disability, or

• Diagnosed with End-Stage Renal Disease (ESRD) or ALS.

Medicare has four main parts:

• Part A: hospital insurance (covers inpatient care and some skilled nursing).

• Part B: medical insurance (doctor visits, preventive services).

• Part C (Medicare Advantage): private plans that combine Parts A and B, often with extras.

• Part D: prescription drug coverage.

Most people pay premiums for Parts B and D. Out-of-pocket costs like deductibles and copays are also part of the picture.

RELATED: What is Medicare Parts A, B, C, and D?

What is Medicaid?

Medicaid is a joint federal-state health insurance program. Every state runs its own version, with federal guidelines. Eligibility depends mainly on income, family size, and sometimes disability status.

Groups that often qualify include:

• Low-income adults

• Children and teens

• Pregnant people

• Older adults with limited income

• People with Disabilities

Medicaid usually covers more services than Medicare, especially long-term care like nursing homes or in-home help. In many states, Medicaid is free or very low-cost for enrollees.

RELATED: What is Medicaid and How Does it Work?

How are Medicaid and Medicare different?

Here’s the side-by-side comparison most people are looking for:

Who Qualifies

• Medicare: Mostly age 65+ or certain disabilities.

• Medicaid: Mostly income-based, with some special categories.

Who Runs It

• Medicare: Federal government (rules are the same everywhere).

• Medicaid: Joint federal-state program (rules vary by state).

What it Covers

• Medicare: Hospital care, doctor visits, preventive services, prescriptions (depending on plan).

• Medicaid: Hospital and doctor care, plus long-term care, home health, and other services Medicare doesn’t always cover.

What it Costs

• Medicare: Monthly premiums, deductibles, and copays.

• Medicaid: Usually free or very low-cost if you qualify.

Can you have both?

Yes. Some people qualify for both Medicare and Medicaid, known as being “dual eligible.” In those cases, Medicare usually pays first, and Medicaid helps cover remaining costs like premiums, deductibles, or nursing home care.

This combination can significantly reduce out-of-pocket expenses for people with limited income who are also eligible for Medicare by age or disability.