Is it Medicare or Medicaid?

man and doctor chatting A lot of people have a difficult time understanding the difference between Medicare and Medicaid. Both programs begin with the letter “M.” They’re both health insurance programs run by the government. People often ask questions about what Medicare and Medicaid are, what services they cover, and who administers the programs.

Let’s start with Medicare. Medicare is the earned-benefit program for Americans aged 65 or older or disabled. Workers pay into Medicare throughout their working years. The Centers for Medicare & Medicaid Services is the agency in charge of both Medicare and Medicaid, but you sign up for Medicare A (Hospital) and Medicare B (Medical) through Social Security.

You can apply for Medicare online from the convenience of your home at the link on our website: www.socialsecurity.gov/medicare/. If you’re already receiving Social Security retirement benefits when you reach age 65 or are in the 25th month of receiving disability checks, we will enroll you automatically.

Medicare Part C (Medicare Advantage) and Part D (Prescription Drug) plans are available for purchase in the insurance marketplace. Social Security administers a program called Extra Help to help people with low income and low resources pay for premiums, co-pays, and co-insurance costs for Part D plans. You can find out more about Extra Help and file for it at www.socialsecurity.gov/medicare/prescriptionhelp. Each year, The Centers for Medicare & Medicaid Services publishes Medicare and You available online at their website at www.medicare.gov/medicare-and-you/medicare-and-you.html. This publication is a user’s manual for Medicare.

Each state runs its own Medicaid program under guidance from the Centers for Medicare & Medicaid Services. Medicaid offers care for the most vulnerable among us. While it does not require paying taxes while working, it does have guidelines about how much income and resources you can have to qualify. Medicaid provides coverage for older people, people with disabilities, and some families with children. Each state has its own eligibility rules and decides which services to cover. The names of the Medicaid program may vary from state to state. You can read about each state’s Medicaid program at www.medicaid.gov/medicaid/by-state/by-state.html. You can find each state’s Medicaid contact information at www.medicaid.gov/about-us/contact-us/contact-state-page.html.

Medicare and Medicaid are two of the major insurance programs that provide healthcare to the American public. Understanding each program, as well as how the two programs differ, can help you and those you care about find the right healthcare program.

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174 thoughts on “Is it Medicare or Medicaid?

  1. Hi, I get Social Security Survivor’s Benefits, in a few months I’ll turn 65 years old. Will I get Medicare and Medicaid when I turn 65? I’m really puzzled by this, because I heard of some people getting both when they turn 65.

    • hi my dad is 72 years old and currently working as caregiver in a care home he never apply for any medicare and doesn’t have any health insurance either i want to apply him online but i dont know which one that he needs and i don’t know what to do, please help how to apply online which one to choose for him how to do it. thanks!

  2. Hello I am on SSDI and was told when I turn 60 I will get my deceased husbands SS I what do I need to do, my birthday is in july

    • Hi Mary, thank you for using our blog. To make an appointment to apply for survivor benefits, please call us at 1-800-772-1213 or you can contact your local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.

  3. Hi I have a friend who has SS & Medicaid she is now 86 but was told that she couldn’t own a home or have one in her name I am totally confused could you please help me in an answer to this question? Thank you so much 🙂

    • Hi Donna, thank you for using our blog. If your friend is receiving Supplemental Security Income (SSI), she can buy a home. However, she should be aware of the SSI resource limit. To be eligible for SSI, a person must have $2,000 or less in countable resources. Not all resources count toward the SSI resource limit. The home she lives in and the land it’s on does not count. Check out our Supplemental Security Income Resources web page for additional details related to resources. We hope this helps!

  4. Could one opt out of the program?

    If so how. I am covered under the veteran administration for my health.

    Is there a requirement that I have to pay into it?

    What is the pros and cons?

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