A question we often get is "What is the difference between Medicare and Medicaid?" At times our members don't even realize there is a difference. Both are government sponsored programs created to help cover health care cost, funded by taxpayer dollars.

Difference between Medicare and Medicaid?

Medicare and Medicaid are two different programs. While you can be a part of both programs, they are not associated.

Medicare is the federal program that provides healthcare, regardless of your income, if you’re older than 65 or have a disability. There are numerous parts to Medicare: Parts A, B, C, and D.

Medicaid is a federal-state assistance program (meaning it varies from state to state) and provides healthcare if you have low income, regardless of age. It also can assist with long-term custodial care for children needing low-cost care whose families earn too much to qualify for Medicaid and are covered through the Children's Health Insurance Program (CHIP) - a program with its own set of byzantine set rules and eligibility requirements.

Key Differences Between Medicaid and Medicare

  • Medicare covers coverage persons ages 65 and older and for those with a disability.
  • Eligibility for Medicare has nothing to do with income level.
  • Medicaid is designed for people with limited income, and often for those without other options.
  • Eligibility for Medicaid is determined on a state-by-state basis.

How Do I Sign Up for Medicaid or Medicare?

If you have been receiving Social Security for at least 4 months when you turn 65, you are automatically enrolled in Medicare Part A and Part B. If you are not automatically enrolled, you can apply at the Medicare website. You also need to consider Parts C (Medicare Advantage) and D (prescription drug coverage). More information can be found at the official website.

Medicaid is a bit more complicated and you need to be eligible to apply. Find out if you're eligible for Medicaid here and apply either via the Health Insurance Marketplace or directly via your state Medicaid agency.

How Much Will Medicare Cost?

A lot of people think Medicare is free…it isn’t. In fact, Medicare and other health cost can be over $100,000 during the course of your retirement. You can use this tool to estimate your health care costs in retirement.


Top photo by Will Francis on Unsplash