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The Difference Between Medicare and Medicaid

Medicaid vs Medicare

Over the years, many people have incorrectly used the terms Medicare and Medicaid interchangeably to the point where there is a lot of confusion among the public. Medicare and Medicaid are two completely different public health insurance options, and it is important to understand their basic differences if you intend to use each service properly.

The Basics

Medicare is a federally-funded form of health insurance that most Americans become eligible for on their 65th birthday. You can get a range of coverage options through Medicare that includes hospitalization, prescription medication, and doctor visits. Some parts of Medicare are free, while others carry a fee. There are no income requirements for Medicare.

Medicaid is a program that is funded at the federal and state levels, but administered individually by each state. You must meet the income requirements in your state to get Medicaid, and there are generally no fees to pay when you qualify. It is possible for one person to qualify for Medicare and Medicaid. This is called dual eligibility.


Medicare is a full health insurance program that is usually utilized by people 65 years of age or older. Medicaid is designed to be a health insurance supplement to help low-income people get the health coverage they need.

Medicare is administered through licensed health insurance carriers by the federal government. Each carrier is allowed to charge a range of premiums for pay services, and there are special supplemental programs that can be offered as well.

Medicaid is generally run by your state through a small group of health insurance carriers. There are usually no premiums to pay, but some services may require a co-payment.

Elderly Care

Medicare is the most common health insurance option for people in the United States 65 years of age or older, but Medicare does not generally get involved with covering long-term care services. Medicaid is the service that Americans apply for when they are looking to transition to assisted living but cannot afford the monthly costs. While Medicaid would pay for the assisted living arrangement, Medicare might still pay for outside medical services.

Application Process

Just prior to an American’s 65th birthday, they are sent a package of information that explains what parts of Medicare they get automatically, and which parts they have to buy. The information packet normally gives the person the information they need to contact carriers who offer supplemental Medicare services.

Medicaid requires an extensive application process that looks back at the way the applicant has managed their assets for the past five years. Because Medicaid deals with long-term care, the application process can be complicated and take many months.

We are experienced in applying for Medicaid services, and we want to help you to get the right health coverage services you need based on your qualifications. Contact our Non-Crisis Medicaid Lawyers to talk about Medicare and Medicaid and find out what needs to be done to make your application process as smooth as possible.


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