Disability, Medicare

Is it Medicare or Medicaid?

November 16, 2017 • By

Last Updated: November 16, 2017

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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Jim Borland, Acting Deputy Commissioner for Communications

Comments

  1. Valerie byerly

    I was told that if my husband and my social security didn’t total a certain amount that we may qualify for help with our Medicare part B could you please tell exactly where I need to go to apply for this help

    • Vonda

      Hi Valerie, thanks for using our blog. You may want to apply for Extra Help with Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $5,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia. In addition to the Extra Help, you may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. By completing the Extra Help application, you will start your application process for a Medicare Savings Program. We will send information to your State who will contact you to help you apply for a Medicare Savings Program unless you tell us not to when you complete the application.

      If you need information about Medicare Savings Programs, Medicare Prescription Drug plans or how to enroll in a plan, call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. You also can request information about how to contact your State Health Insurance Counseling and Assistance Program (SHIP). The SHIP offers help with your Medicare questions. We hope this helps.

  2. Kris

    I receive Extra Help (Medicare Savings Program). Is this considered Medicaid? Thanks.

    • Vonda

      Hi Kris, thanks for using our blog. The Medicare Savings Programs are administered by your state or local social services office. You can visit the U.S. Department of Health and Human Services web page for more information. Thanks.

  3. Laura William

    In the event that so how. I am covered under the veteran organization for my wellbeing. Is there a prerequisite that I need to pay into it?
    What is the upsides and downsides?

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  4. Nicholas

    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?

    • Vonda VanTil, Public Affairs Specialist

      Thank you for your service, Nicholas! Enrolling in Medicare is your choice. However, because you can only sign up for Medicare Part B during designated enrollment periods, if you choose not to enroll when first eligible and later change your mind, you may have to pay a late enrollment penalty for as long as you have Part B coverage.

      Check out the Veterans Administration web page for additional details on VA health care and how it works with Medicare and other health insurance.

  5. Mary Jeane Callahan

    I have medicare and medicaid. do I need to reregister or and qualify again?

    • Vonda VanTil, Public Affairs Specialist

      Hi Mary Jeane, thanks for using our blog. It sounds like you are all set. Of course, if you have any questions with your Medicare, you can 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.

      You can get information about Medicaid from your state or local social services office. You can visit the U. S. Department of Health and Human Services (HHS) web page for more information. We hope this information helps.

  6. Donna Riggs

    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 🙂

    • Vonda VanTil, Public Affairs Specialist

      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!

  7. Mary Mccann

    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

    • Vonda VanTil, Public Affairs Specialist

      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.

  8. Reader

    Nice article. I found this article very detailed and useful about What Is Depression ? Symptoms, Treatment, Causes

    • Mary

      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!

      • Vonda VanTil, Public Affairs Specialist

        Hi Mary, thank you for using our blog. Check out our Frequently Asked Questions web page for details on how to sign up for Medicare.

        If your dad still has questions, he can call us at 1-800-772-1213 or he can contact his 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.

  9. Maggie

    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.

    • Vonda VanTil, Public Affairs Specialist

      Hi Maggie. If you already get Social Security benefits, we’ll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). We’ll mail you all the information you need a few months before you become eligible. Check out our Frequently Asked Questions web page for additional details on Medicare enrollment.

  10. Maria

    I just qualified for Medicaid can I cancel Medicare I’m on social security

    • Vonda VanTil, Public Affairs Specialist

      Hi Maria, thank you for your question. Medicaid never pays first for services covered by Medicare. It only pays after Medicare, employer group health plans, and/or Medicare Supplement (Medigap) Insurance have paid. Visit Medicare’s web page on Medicaid for more details. We hope this is helpful.

      • Barbara

        I have a question. Should someone who was on SSI then tried to work for 3 years now on SSDI be on medicare or medicaid?? and only 33.

        • Vonda VanTil, Public Affairs Specialist

          Hi Barbara, thanks for your question. After you receive disability benefits for 24 months, you’ll be eligible for Medicare. You will get information about
          Medicare several months before your coverage starts. If you have permanent kidney failure requiring regular dialysis or a transplant or you have amyotrophic lateral
          sclerosis (Lou Gehrig’s disease), you may qualify for Medicare almost immediately. Check out our publication What You Need to Know When You Get Social Security Disability Benefits for more information.

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