Christine Biemuller | Apr 30 2025 14:00
When it comes to healthcare coverage, “Medicare vs Medicaid” is one of the most common questions we hear. While both programs are designed to help cover medical costs, they serve different groups of people and offer different types of benefits. Let’s break it down in simple terms.
What is Medicare?
Medicare is a federal health insurance program primarily for people who are:
- 65 and older
- Under 65 with certain disabilities
- Any age with End-Stage Renal Disease (ESRD)
Medicare is divided into four parts:
- Part A: Covers hospital stays, skilled nursing facilities, hospice, and some home health care.
- Part B: Covers doctor visits, outpatient care, medical supplies, and preventive services.
- Part C (Medicare Advantage): Offers an alternative way to get your Medicare benefits through private insurance companies. Often includes extra benefits like vision and dental.
- Part D: Covers prescription drugs.
Who pays?
Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working. Part B usually has a monthly premium, and there may be out-of-pocket costs like deductibles and copayments.
What is Medicaid?
Medicaid is a state and federal program that provides health coverage for:
- Low-income individuals and families
- Pregnant women
- Children
- People with disabilities
- Some seniors who also qualify for Medicare
Medicaid benefits vary by state, but typically include:
- Doctor visits
- Hospital services
- Long-term care (like nursing homes)
- Home health services
- Some dental and vision care
Who qualifies?
Eligibility is based on income and resources. Each state has its own guidelines, so what’s covered (and who qualifies) can differ depending on where you live.
Medicare vs Medicaid: Key Differences at a Glance
| Feature | Medicare | Medicaid |
|---|---|---|
| Who it serves | Primarily seniors 65+, some younger people with disabilities | Low-income individuals and families, including some seniors |
| How it's funded | Federal government | Joint federal and state program |
| What it covers | Hospital, medical, and prescription drug coverage | Broader health services, including long-term care |
| Cost to you | Usually involves premiums, deductibles, and copays | Low or no cost, depending on income and state |
Can You Have Both?
Yes! Some people qualify for both Medicare and Medicaid, known as “dual eligibility.” In these cases, Medicare covers your primary medical services, and Medicaid may help with costs like premiums, copays, and long-term care.
Need Help Understanding Your Options?
At Your Senior Savior, we specialize in helping seniors and their families navigate healthcare choices with confidence. Whether you’re trying to decide between Medicare Advantage plans or seeing if you qualify for Medicaid, we’re here to guide you every step of the way.
Have questions about Medicare vs Medicaid?
Reach out to us today—because peace of mind starts with understanding your coverage.