{"id":65,"date":"2015-07-29T14:30:25","date_gmt":"2015-07-29T18:30:25","guid":{"rendered":"https:\/\/singlecare.com\/blog\/?p=65"},"modified":"2025-12-12T17:38:02","modified_gmt":"2025-12-12T22:38:02","slug":"difference-between-medicare-and-medicaid","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/difference-between-medicare-and-medicaid\/","title":{"rendered":"Medicare vs. Medicaid: What are the differences?"},"content":{"rendered":"

Many Americans may be familiar with the concept of Medicare and Medicaid, but what are the key differences between Medicare vs. Medicaid? They are both government-administered health insurance programs to help with healthcare costs. Medicare is a federal program that covers adults who are 65 and older as well as younger people with certain disabilities. Medicaid is funded by the federal and state governments and it covers people of all ages with a low income.<\/span><\/p>\n

Medicare<\/span><\/h2>\n

Medicare and Medicaid programs came to fruition on Jul. 30, 1965, when President Lyndon B. Johnson signed a bill providing healthcare coverage for older individuals. This \u201cOriginal Medicare\u201d only included Medicare Part A and B. The<\/span> first two Medicare beneficiaries<\/span><\/a> were none other than Harry Truman and his wife, Bessie.\u00a0<\/span><\/p>\n

Medicare covers seniors ages 65 and older as well as people younger than 65 with certain disabilities. There are<\/span> four different parts of Medicare<\/span><\/a>: Part A, B, C (Medicare Advantage), and D. Each part covers different healthcare services.<\/span><\/p>\n

RELATED:<\/b> What is Medicare?<\/b><\/a><\/p>\n

Medicaid<\/span><\/h2>\n

Medicaid is a public insurance program for all ages that provides health coverage to certain people with a low income. In addition to funding from the federal government, it is also partially funded by each state\u2019s government. Medicaid can cover certain older adults, people with disabilities, children, pregnant women, parents, and caretakers of children.<\/span><\/p>\n

RELATED:<\/b> What is Medicaid?<\/b><\/a><\/p>\n

What is the difference between Medicare and Medicaid?<\/span><\/h2>\n

\u201cThey\u2019re both government-run programs, but they cover different populations of people,\u201d explains<\/span> Kate Ashford<\/span><\/a>, Medicare specialist at NerdWallet. \u201cMedicare mainly covers people ages 65 and older, while Medicaid primarily covers low-income and vulnerable people of any age. And while they\u2019re both federal programs, Medicare is run by the federal government, and Medicaid is run by individual state and local governments.\u201d\u00a0<\/span><\/p>\n

Not everyone is eligible for Medicare and\/or Medicaid coverage. Here are the general qualifications and coverage details of each government program.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n
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Medicare vs. Medicaid<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nMedicare<\/b><\/td>\nMedicaid<\/b><\/td>\n<\/tr>\n
Eligibility<\/span><\/td>\nPeople 65 or older and some younger people with certain disabilities and End-Stage Renal Disease or ALS<\/span><\/td>\nEligibility varies from state to state depending on income and family size. The federal government makes the minimum eligibility standards, but states can be more generous. Eligibility also depends on what population of applicants you fall into (i.e., age or disability) or through a different standard. There are many different Medicaid programs with different eligibility standards.<\/span><\/td>\n<\/tr>\n
Coverage<\/span><\/td>\nPart A: Hospital services<\/span><\/p>\n

Part B: Outpatient services (such as doctor\u2019s visits<\/a>, laboratory tests, X-rays, etc.)<\/span><\/p>\n

Part C: Part A and B coverage, typically Part D, and some additional services may apply<\/span><\/p>\n

Part D: Prescription drugs<\/span><\/td>\n

Coverage varies state by state and Medicaid category, but there are mandatory benefits that must be provided, such as hospital and physician services, laboratory testing, X-rays, and home health services<\/span><\/td>\n<\/tr>\n
Costs<\/span><\/td>\nPart A monthly premiums can range from $0-$565\/month, depending on work history<\/span><\/p>\n

Part B premiums may be $202.90\/month or higher, depending on income<\/span><\/p>\n

Part C costs vary by plan, but the average premium is $14\/month<\/span><\/p>\n

Part D costs vary by plan, but the nation base premium is $38.99\/month<\/span><\/p>\n

Other costs apply and vary across the different parts of Medicare, including deductibles, copay, coinsurance, and late enrollment penalties<\/span><\/td>\n

Charges vary by state and program, and they may include premiums, deductibles, coinsurance, and copays<\/span><\/td>\n<\/tr>\n
Enrollment<\/span><\/td>\nSome people are automatically enrolled in Parts A and B. If you aren\u2019t automatically enrolled, you can enroll in certain parts of Medicare during the following enrollment periods:<\/span><\/p>\n

Initial Enrollment: Starts 3 months before turning 65 and 3 months after your birthday<\/span><\/p>\n

Parts A and B General Enrollment: Jan. 1-Mar. 31\u00a0<\/span><\/p>\n

Part D Open Enrollment: Oct. 15 to Dec. 7<\/span><\/p>\n

Special Enrollment: Varies by qualifying event<\/span><\/td>\n

You can apply for Medicaid through the Health Insurance Marketplace or your state\u2019s Medicaid agency. Initial enrollment can be done year-round, and you can change plans once per month.\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Eligibility<\/span><\/h2>\n

Medicare<\/b> eligibility requirements for those 65 and older include:<\/span><\/p>\n