Medicare and Medicaid sound similar but serve very different populations. Learn who qualifies, what each covers, and how they can work together.
Medicare: Age and Disability-Based Coverage
Medicare is a federal program primarily for people 65 and older, regardless of income. It also covers younger people with certain disabilities and those with End-Stage Renal Disease (ESRD). Medicare has four parts: Part A (hospital), Part B (medical), Part C (Medicare Advantage), and Part D (prescriptions).
Medicaid: Income-Based Coverage
Medicaid is a joint federal-state program for people with low incomes. Eligibility varies by state — in Medicaid expansion states, adults earning up to 138% of the federal poverty level ($20,783 for an individual in 2026) qualify. Medicaid covers more services than Medicare, including long-term care, dental, and vision in many states.
Dual Eligibility
Some people qualify for both Medicare and Medicaid simultaneously (called "dual eligible"). In this case, Medicare is the primary payer and Medicaid covers remaining costs including premiums, deductibles, and copays. Dual eligibles typically pay nothing out of pocket for covered services.
Coverage Comparison
Medicare does not cover dental, vision, hearing, or long-term care without supplemental plans. Medicaid covers all of these in most states. However, Medicaid has much more limited provider networks — many doctors don't accept Medicaid due to low reimbursement rates. Medicare is accepted by 97% of physicians nationwide.
Disclaimer: This guide is for informational purposes only and does not constitute financial or medical advice. Always consult with qualified professionals before making healthcare or insurance decisions.