What is Medicaid?
Many people confuse Medicaid and Medicare. But they’re not the same.
Medicaid Overview & How It Differs from Medicare
Medicaid is a joint federal–state health insurance program that provides coverage for people with low income and limited resources. Unlike Medicare (age/disability-based), Medicaid eligibility is based on financial need and rules vary by state.
Key Features of Medicaid
Comprehensive Coverage
Hospital, doctor visits, preventive services, labs, and in many states, long-term care (nursing home or in-home support).
Low or No Cost
Most enrollees pay little to nothing for covered services; some states charge small copays or premiums.
State-Administered
Funded by federal and state governments but run by states, so eligibility, benefits, and costs vary by where you live.
Medicare vs. Medicaid: Key Differences
| Feature | Medicare | Medicaid |
|---|---|---|
| Who Qualifies | Primarily people 65+, and younger individuals with certain disabilities or conditions (ESRD, ALS). | People of all ages with low income and limited resources (rules vary by state). |
| Type of Program | Federal program – same nationwide. | Joint federal & state – varies by state. |
| Costs | Premiums, deductibles, coinsurance (e.g., Part B premium, Part D drug costs). | Usually low or no cost; some states charge small copays/premiums. |
| What It Covers | Hospital (Part A), medical (Part B), prescriptions (Part D), or Medicare Advantage (Part C). | Comprehensive care, often including hospital, doctor, preventive, prescriptions, and long-term care. |
| Long-Term Care | Limited (short-term skilled nursing/rehab after a hospital stay). | Primary payer of long-term care (nursing homes, in-home assistance). |
| Administration | Run by the federal government. | Run by states within federal guidelines. |
| Can You Have Both? | Yes — “dual eligible” beneficiaries. Medicaid may help pay Medicare premiums and out-of-pocket costs. | Yes — coordinates with Medicare to cover costs/services Medicare doesn’t. |
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