Medicare vs. Medicaid: What’s the Big Difference?

November 24, 2019

Medicare and Medicaid are programs that provide government assistance to individuals in need of healthcare support. As you consider what health coverage is best for you, Benefits.gov wants to help you understand some of the key differences between Medicare and Medicaid.

Who is eligible?

1. Medicare is available for people 65 years or older or people under 65 with a qualifying disability or end-stage renal disease.
2. Medicaid eligibility requirements vary from state to state and depend on factors such as your household income, family size, or disability. Use the Filter by State feature on Benefits.gov to find your state’s Medicaid Program and to check if you may be eligible.

What is covered?

1. Medicare coverage depends on if you have Original Medicare or Medicare Advantage. Generally, Original Medicare includes Part A which covers hospital services and Part B which covers medical services. Medicare Advantage coverage includes Part A, Part B, and usually Part D which covers prescription drug costs. Visit Medicare.gov to find more information on the services covered by each Medicare plan.
2. According to Medicaid.gov, all states are required to cover certain services including inpatient and outpatient hospital services, laboratory and x-ray services, physician services, nursing facility services, and more. States have the choice to cover other optional services such as prescription drugs, physical therapy, occupational therapy, and dental services. Find out what services your state’s Medicaid Program covers by contacting your state Medicaid agency. 

How can I apply?

1. To apply for Medicare, visit Medicare Benefits on the Social Security Administration's website during the open enrollment period, which runs from November 1 - December 15, and submit an application online. 
2. You can apply for Medicaid and enroll any time of year. Contact your state Medicaid agency for more information or submit an application through the Healthcare.gov Health Insurance Marketplace. Find more tips in our recent article: How to apply for Medicaid in your state.

To discover more government benefits you may be eligible to receive, complete our Benefit Finder questionnaire. The Benefit Finder will ask you a series of questions and compare your answers with the eligibility requirements of over 1,200 government benefits, to check your eligibility. While you cannot apply for benefits directly on Benefits.gov, we can help you find information on how to apply and direct you to the managing agencies who can answer your questions.

https://www.benefits.gov/news/article/384