What is the Difference Between Medicare and Medicaid?

Learn the difference between Medicare and Medicaid, who qualifies for each program, and how dual eligibility can help lower healthcare costs.

Medicare and Medicaid are both government-run health programs, but they serve different purposes. Medicare primarily provides coverage for people age 65 and older, as well as certain younger individuals with disabilities. Medicaid offers healthcare coverage to people with limited income and resources, regardless of age.

Key Differences Between Medicare and Medicaid

• Medicare: Federal program, mostly for people 65+ or with certain disabilities.
• Medicaid: Joint federal and state program for low-income individuals and families.
• Funding: Medicare is funded by federal payroll taxes; Medicaid is funded by both federal and state governments.
• Coverage: Medicare has Parts A, B, C, and D; Medicaid benefits vary by state.

Who Is Eligible for Both Medicare and Medicaid?

Some individuals qualify for both programs—these people are called “dual-eligible” beneficiaries. Dual-eligible individuals typically have Medicare as their primary coverage and Medicaid as secondary, helping to cover costs Medicare doesn’t pay, such as premiums, deductibles, and certain services.

Benefits for People with Both Medicare and Medicaid

• Lower out-of-pocket costs for healthcare services.
• Coverage for additional services like long-term care that Medicare may not cover.
• State-specific benefits and support programs.