Is it Medicare or Medicaid?
Reading Time: 2 MinutesLast Updated: July 16, 2021
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 on our Medicare Benefits page. 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 on our Extra Help with Medicare Prescription Drug Plan Costs page. Each year, The Centers for Medicare & Medicaid Services publishes Medicare and You available online at their website. 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 on their State Overviews page. You can find each state’s Medicaid contact information on the Contact Your State With Questions page.
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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Tags: Disability, Medicaid, Medicare
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Jim Borland, Acting Deputy Commissioner for Communications
Jim Borland, Acting Deputy Commissioner for Communications
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Patricia K.
You are dealing with a lot of seniors. Make the typeface LARGER. Too difficult to read!
RYU C.
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Barbara M.
My husband will be 62 yrs old come Aug 2018 he is receiving disability checks once a month as he will never be able to work again
What does he qualify for as I find it all confusing
R.F.
Hi Barbara, when a person receives disability benefits under the Social Security Disability Insurance (SSDI) program, we will automatically convert their disability benefits to retirement benefits, when they attain their Full Retirement Age. The benefit amount will generally remain the same. Also, we automatically enroll disabled beneficiaries in Medicare after they get disability benefits for two years. Visit our Disability Planner: Social Security Protection If You Become Disabled, for more important information.
tony
I get Medicare for a disability. I call it my early retirement money and healthcare.
D.H. F.
Thank you. That’s a clear, straight-to-the-point explanation.
Stanley J.
I have been living overseas since 1963. I worked as a Civil Service employee of the US Government in Germany and retired from government service in 1998. I moved to Italy after I retired and I am still living in Italy.
I understand Medicare is not available outside the USA. In that regard I enrolled in Medicare Part A because no costs are involved. However I would have to pay for Part B if I enrolled. I see no reason to pay for something that I cannot use. On the other hand if I ever returned to the USA and would want to enroll in Part B I would have to pay retroactively for all the years that I was not enrolled even though I live in Europe and could not receive the benefits of Part B. This seems unfair to me and cannot think of any reason why the retroactive payments are required.
Can you help me understand the logic of this situation?
R.F.
Hi Stanley. Generally, U.S. citizen receiving Social Security retirement benefits and turning 65 while living in a foreign country are initially notified of their eligibility for Medicare, 3 months before the month of their 65th birthday. Automatic enrollment does not apply to people living in foreign countries.
Medicare Part B is optional. Beneficiaries may refuse the coverage and if they file a written notification before Part B coverage starts, we always consider this a timely refusal. Timely refusals do not incur premium charges.
The Supplementary Medical Insurance (SMI) premium (Part B) is increased 10 percent for each full 12 months during which an individual could have been, but was not, enrolled in SMI.
An exception to the increased premium is a beneficiary delays enrollment in Medicare Part B due to continued employment with Group Health coverage. When enrollment is delayed for any other reason, such as living outside the U.S., the Part B premium surcharge will apply when returning to the U.S. and enrolling in Medicare Part B. In addition, the only enrollment period option is the General Enrollment Period (GEP) in the first three months of each year, which coverage beginning in July of the enrollment year. Please contact your local U.S. embassy or consulate for any assistance related to your Social Security benefits. Medicare is an extensive subject, please visit http://www.ssa.gov/medicare/ for more information.
Damon A.
My Assurance supposed to be active please call him and let me know what’s going on
qutub a.
I am over 70 and am a green card holder. I have never worked in US, how do I get medicare Part A & B
R.F.
Thank you for your question. If you are a lawfully admitted permanent resident or a green card holder, not insured for Social Security benefits, age 65 or older, who has continuously resided in the U.S. for 5 years or longer, you may still be able to purchase Medicare Part A & B. Also, if you’re married and if your spouse is at least 62 and insured for Social Security benefits, you could be eligible for Medicare benefits. You can call our toll free number at 1-800-772-1213 for further assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m.
Jeannette M.
Why is it so difficult to make a change of address? By phone I was told my wait would be an hour. By online I was unable to find where I should enter the change and after a considerable time (perhaps a 1/2 hour) I gave up! Consequently I still have been unable to post the change.
R.F.
Hi Jeannette, we are sorry to hear that you’re having difficulty trying to change your address. If you are receiving Social Security retirement or disability, or have Medicare, you can create a my Social Security account to change your address online. If you have already created an account but are having difficulty accessing it, please call 1-800-772-1213 for assistance. After you hear “Briefly tell me why you are calling,” say “Help Desk” for help with a my Social Security account.
If you are receiving Supplemental Security Income, you need to contact your local office to update your records.
If you do not receive Social Security benefits, SSI or Medicare, you do not need to change your address with us. We hope this helps!
John T.
In a simple format this is good information that the majority of people should be able to understand. Also please send a copy of this to every member of the House and Senate of the United States highlighting the second paragraph. Thanks.