Disability, Medicare

Is it Medicare or Medicaid?

November 16, 2017 • By

Reading Time: 2 Minutes

Last Updated: July 16, 2021

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 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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About the Author

Jim Borland, Acting Deputy Commissioner for Communications

Jim Borland, Acting Deputy Commissioner for Communications

Comments

  1. candace j.

    first time medicare apply

    • Vonda V.

      Hi Candace. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B.

      If you are at least 64 years and 9 months old and aren’t receiving Social Security benefits, you can apply for Medicare A and B online.

      If you already have Medicare Part A and need to sign up for Medicare Part B, there are some forms that you will need to complete. See our Frequently Asked Questions web page for details.

  2. Chiquita A.

    I will be 65 May 2019. S
    I am not retiring. Am I supposed to apply for Medicare A?

    • Ann C.

      Hi, Chiquita. If you are still working and covered under a group health plan based on that employment, you may not need to file for Medicare parts A or B until you stop working or drop your health care coverage. We always suggest that individuals speak to their personnel office, health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. Please contact your local Social Security office for further assistance or call our toll-free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7:00 a.m. and 7:00 p.m. We hope this helps.

  3. Linda W.

    Ok i have a question, I am disabled, when can i apply for Medicaid or Medicare?

  4. Elizabeth S.

    HI Elizabeth Marie Sutton needs a Medicaid card new one my Medicaid card I never got one my number is#0014533584 and I need a social security card too my number is *** – ** – *** I used to live in Kennett,Mo 63857 My maiden name is Elizabeth Marie Wellington.My mother name is Ethel Emogene Wellington and my daddy name is Sam Wellington.

  5. Dixie L.

    I can’t find my Medicare card is there a office to get another to replace it?

  6. Kevin V.

    When does Medicaid

  7. Senior H.

    When CMS overhauls its Electronic Health Record (EHR) how will it affect
    supplemental health insurance costs & Medicare Open Enrollment 2019?

  8. Nancy R.

    I was forced to go on disability after working for 40 years and only 5 years from retirement. I started receiving my didability at age 59. I just got my Medicaid card this past April 2018. So am I still considered disablility or is it early retirement benefits.? I’m 64 now. Also, now that I’m on Medicare, am I restricted on how much I can earn by working part time now? Also, when I turn 65, shouldn’t my monthly benefit amount go up by a few hundred dollars. I was told it would when I started on disability.

    • Ray F.

      Hello Nancy. First, Social Security disability benefits automatically change to retirement benefits when disability beneficiaries attain their full retirement age. Benefits are not interrupted with this transition and the benefit amount will generally remains the same. Also, keep in mind that disability benefits are established at the highest rate possible, no reductions factors are applied to your disability benefit amount.
      Your monthly benefit amount is based on the average of your lifetime earnings before you became disabled. Generally, we use the highest years of earnings to calculate your monthly benefit amount. If you continue to work, and your earnings for the prior year are higher than one of the years we used to compute your retirement benefit, we will recalculate your benefit amount. If an increase is due, a new monthly benefit amount is established on your record automatically.
      Social Security strongly supports those individuals who want to return to the work force while supplementing their disability benefit income. We have Work Incentives that allow people to work and still receive their benefits. A person may still be eligible for disability benefits under the Social Security Disability Insurance program if they work. However, their earnings cannot exceed a certain amount. This is called the Substantial Gainful Activity (SGA) limit. In 2018, the SGA limit is $1,180 per month (or $1,970 for blind applicants). In addition to the amount of money you make, Social Security may also look at the number of hours you’re able to work.
      We hope this information helps!

  9. Tony C.

    I am 70 years old, still working and my wife and I are currently drawing SS benefits….I want to retire early next year and am confused with all the Medicare/Medicaid offers we get through the mail…can I visit the local SS Admin office to get advise as to what to purchase and what I would need and how much it’s going to cost me?

    • Ray F.

      Hello Tony. The 2019 plans are now available to review and compare. Visit The Medicare Plan Finder or contact Medicare.gov for more information and to discuss the options you may have. You can join a plan starting October 15, 2018 through December 7, 2018.
      For general information on the Medicare enrollment periods visit our web page: Medicare Benefits. Thanks!

  10. Steve

    I receive SSDI and I get Medicare, when do I apply for Medicaid. I was told in October. I didn’t have it last year because I didn’t know what I needed to do. My doctor has put in for medicine I need to take, but when I went to get it I didn’t have enough money for it, they said I need to have Medicaid to get medicine.

    • Ray F.

      Hello Steve. Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. Also, you may want to check and see if you are eligible to receive social services from the state in which you live. These services include Medicaid, which may help pay for medication that Medicare does not cover.
      You can get information about services in your area from your local social services office. Or you can visit the U.S. Department of Health and Human Services web page for more information.
      We hope this helps!

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