Medicare vs Medicaid

Eligibility, cost, and coverage compared side by side. Call 1-800-MEDIGAP for free clarity.

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Quick answer

Medicare is federal health insurance based on age (65+) or disability, regardless of income. Medicaid is a joint federal-state program based on low income and need. Some people qualify for both, called dual eligibility, where Medicaid helps pay Medicare's premiums and out-of-pocket costs.

Medicare and Medicaid sound alike but work very differently. Here is how to tell which program fits your situation, or whether you qualify for both.

What is the main difference between Medicare and Medicaid?

The core difference is the basis of eligibility. Medicare qualifies you by age or disability, not income, so a wealthy 65-year-old and a low-income 65-year-old both receive it. Medicaid qualifies you by financial need, with income and asset limits set by each state. Medicare is federally run and consistent nationwide; Medicaid is run by states under federal rules, so benefits vary by where you live. If you are unsure which you qualify for, call 1-800-MEDIGAP for a free review.

Can you have both Medicare and Medicaid?

Yes. People who qualify for both are called dual eligibles. For them, Medicare is the primary payer for most medical services, while Medicaid acts as a secondary safety net, often paying Medicare premiums, deductibles, and coinsurance, plus services Medicare does not cover such as long-term custodial care. Dual eligibles may also qualify for Special Needs Plans. If you think you might be dual eligible, a licensed agent at 1-800-MEDIGAP can confirm and explain your benefits.

More on Medicare Basics & Enrollment

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Frequently asked questions

Is Medicaid better than Medicare?+

Neither is universally better; they serve different purposes. Medicare provides broad coverage based on age or disability, while Medicaid provides need-based coverage that can pay for long-term care Medicare excludes. For those who qualify for both, the programs work together to minimize out-of-pocket costs.

Does Medicaid pay my Medicare premiums?+

It can. Through Medicare Savings Programs, Medicaid may pay your Part B premium, and sometimes Part A premiums, deductibles, and coinsurance, if your income qualifies. This can save you over $2,400 a year on Part B alone. Call 1-800-MEDIGAP to check your eligibility.

Can I lose Medicaid but keep Medicare?+

Yes. Medicare eligibility is based on age or disability and does not end if your income rises. Medicaid eligibility depends on income and can end if you no longer meet the limits. You would keep Medicare but lose the Medicaid help with premiums and extra services.

Which pays first, Medicare or Medicaid?+

For dual eligibles, Medicare pays first as the primary insurer, and Medicaid pays second for costs Medicare leaves, such as coinsurance and deductibles, plus services Medicare does not cover. This coordination keeps out-of-pocket costs very low. 1-800-MEDIGAP can explain how it applies to you.

Do I still need a MEDIGAP plan if I have Medicaid?+

Usually not. If you have full Medicaid, it already covers most of the gaps a MEDIGAP plan would, so buying one is generally unnecessary. If your Medicaid is partial, your needs may differ. A licensed agent at 1-800-MEDIGAP can advise you at no charge.

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