Medicare vs Medicaid: What’s the Difference between Medicare and Medicaid?



Many people have questions about Medicare and Medicaid including the question of what the differences are between the programs. There are some major differences between the two.

Medicare is funded by the federal government as an entitlement program, which mainly focuses on the older population. It is a social insurance program for individuals age 65 and over and it covers many individuals with disabilities. Medicare also covers individuals of all ages with end stage renal disease.

There are several parts to Medicare. Part A covers hospital bills, Part B covers medical insurance and Part D covers prescriptions.

Medicaid is different from Medicare in several ways. It is also an entitlement program, however, Medicaid is not funded only by federal government, there is a state component as well, and in some states, counties pay part of the cost.

Medicaid is based on need and social welfare, with eligibility based on income. If a person has limited income and/or financial resources, Medicaid covers a broader spectrum of services than Medicare does. It usually covers children, pregnant women, parents of eligible children, seniors and individuals with disabilities. Though poverty is used to determine eligibility, a person must fall into one of the coverage groups in addition to being determined eligible due to being in poverty. Medicaid benefits are paid directly to the provider of services. In addition to covering individuals who meet financial requirements, in some states Medicaid covers individuals who cannot otherwise afford insurance.

Some individuals qualify for coverage by both programs.

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4 Comments Add your own

  • 1. sandra parsons  |  July 14th, 2009 at 6:24 am

    how can i get medicare
    i got turned down for medicaid

    thanks

  • 2. Marina  |  March 18th, 2010 at 12:03 pm

    My parents are Russian immigrants. They will be US citisens in 6 months or so. They are 67 and 68 y.o. They are covered by Medicaid — which is a tremendous blessing! We are so thankful and appreciate what has been done for them in this country. My father has been fighting lung cancer for a year now. His treatments, Dr. visits, tests and medications are completely covered by Medicaid. Once they are naturalized they will qualify for Medicare. Will they have to choose between Medicare and Medicaid? They have not worked in US. My father worked just a few months and due to his health could not work any more. Will Medicare be as comprehensive in health care coverage as Medicaid? Who qualifies for both plans?
    I would appreciate some input on these questions.
    Thank you.
    Marina.

  • 3. Kyle  |  April 29th, 2010 at 8:08 am

    Medicare is only available for those above the age of 60

  • 4. Kathy Jansma  |  April 30th, 2010 at 7:36 am

    We have an employee who just qualified for disabiity benefits b/c he is legally blind. He is 61 and lives in the state of Michigan. Would he be eligible for any additional benefits from Medicare or Medicaid?

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