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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Christi
___123___Is it Medicare or Medicaid? | Social Security Matterss___123___
Karen
Termination of mother’s SSI caused her Medicaid to be pulled back. She lives in a nursing facility – what do we need to do?
George B.
My spouse is a non- US citizen. I have read that at the event that I pass away my spouse will have to pay a 60 percent income tax on her SS benefits. WHY!
Ray F.
See our Frequently Asked Questions web page on “Noncitizens“. For tax questions, you will need to contact the IRS. Their toll-free number is 1-800-829-1040. We hope this helps.
Yugank K.
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DENNA M.
How do I sign up for the special enrollment period for Medicare Part B? I still work full time and don’t need the Part B yet.
Ray F.
Hi Denna! You may have the chance to sign up for Medicare during a Special Enrollment Period (SEP), if you’re covered under a group health plan based on current employment. You will have an 8-month SEP to sign up for Medicare Part B. The 8-month period begins the month after the employment ends or the month after group health plan insurance based on current employment ends.
If you need to terminate your Medicare Part B, our policy requires that a personal interview be conducted with a Social Security representative. We will help you submit the required form, or your signed request for termination.
To make an appointment or to speak with one of our agents for further assistance, call our toll free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. We hope this helps!
Paul F.
Does Medicare or Medicaid make phone calls to citizens? With all the scams going on now, I am reluctant to provide any information to someone claiming to be with Medicare. Especially if the person claiming to work with Medicare has a foreign accent. I usually just hang up om them.
Ray F.
Hi Paul. Government employees occasionally contact citizens by telephone for customer-service purposes. We may call you in limited situations, such as if you recently filed a claim or have other business that are pending.
Please be suspicious of unsolicited phone calls, or email messages. If an unknown individual claims to be from a legitimate organization, try to verify his or her identity directly with the company. Avoid providing personal information unless you are certain of a person’s authority to have the information. Thanks!
P b.
I am on Medicaid and just turned 65, I am also collecting Social Security,Soc Sec took 134.00 dollars out of my benefits and I don/t think its fair! Can any one tell me how to rectify that process and decline the Medicare removal of that kind of monthly money? Thanks
David G.
What is the 2018 SSDI monthly earnings cap?
Jenna Y.
Happy New Year, David! In 2018 the Substantial Gainful Activity limit for SSDI is $1,180 per month (or $1,970 for blind applicants). We count the gross amount of your monthly wages. In addition to the amount of money you make, Social Security may also look at the number of hours you’re able to work. Social Security has Work Incentives for people on disability who want to work. See our publication “Working While Disabled – How We Can Help” and visit our Frequently Asked Questions web page on disability for more information. Please call our toll free number at 1-800-772-1213 and speak to one of our agents for further assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Thanks.
John
Medicare is for those that worked and paid into it. Medicaid is for those that were too lazy to work and can’t get Medicare.
Karen
I just retired after working 31 years, so I guess if I wind up needing to be in a nursing home, I was a lazy one??
S B.
John you are CRAZY and EVIL
Carol M.
Received Benefit notification stating that I should pay $134 per month for Medicare. According to information I received, this amount is what I would pay IF I was not receiving Social Security. If I was on Medicare and receiving Social Security my payment would be only $109. This is due to a law that prevents Medicare premiums from cutting into Social Security benefits. Last year my payment was $110 per month.
Could you please explain?
Ray F.
Unfortunately, but for security reasons, we do not have access to personal records in this blog. Please call our toll free number at 1-800-772-1213 for assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Generally, you will have a shorter wait time if you call later in the week. Thanks.