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. I signed up for Medicare I thought Medical would go away, received letter stating that I will be on Medicare/Medicad, Can’t find letter and do not want Medical or Medicad at all. Letter stated there is a form that I must use to remove myself from Medicad. Can you please supply me with form # and is it a Social Security form or state medical form. I want to get this settled so they will deduct Medicare from SS payment check so it does not disturb my Medicare insurance

  2. I AM A SENIOR AGE 80 YEARS OLD AND NEED ASSISTANCE WITH MY SOCIAL SECURITY FOR HEALTH REASONS. WHERE DO I GO FOR HELP.

  3. it is very confusing. im on long term Medicaid I have ms. why would I want to pay for part b when I have no copays

  4. I am trying to cancel my Medicare coverage and appealing now to retain my Medicaid. The only reason I signed up for either one was to be able to get some dental work done. I am already getting medical coverage thru the VA and I am a veteran. Can someone please tell me how to cancel my Medicare coverage

    • Hi, David. Thanks for your question. To terminate your enrollment, we will help you submit a signed request for termination or Form CMS-1763. The Centers for Medicare & Medicaid Services (CMS) requires, when possible, a personal interview be conducted with everyone who wishes to terminate entitlement. Therefore, we do not offer form CMS-1763 online. For an interview, you can call us at 1-800-772-1213 (TTY 1-800-325-0778) 7 a.m. to 7 p.m., Monday through Friday or go to your local office. Generally, you’ll have a shorter wait time if you call later in the day. We hope this helps.

  5. They tell me that when I return 65 that you don’t have to pay for Medicare I want to know if it’s true because I’ve been paying for it and I just turn 69.

    • Hi, Luis. Thanks for your question. If you are already getting Social Security retirement benefits, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you are not already getting retirement benefits, you should contact us about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65. To learn more about Medicare, visit here. We hope this helps.

  6. Im turning 65 this month but plan to work for several years more, with no intention of taking SS payment until 70Yr.. Do I need to sign-up with Social Security or Medicare anyway? I work for a large company and will continue to receive health insurance through them.

    • Hi, Patricia. Please bear in mind that the decision on when to apply for benefits is a personal one. We can only provide you with the information to help you make the best choice according to your own situation. Eligible individuals can start receiving retirement benefits as early as age 62, but if you decide to start receiving benefits after your full retirement age, it may result in larger benefits. You earn delayed retirement credits automatically when and if you delay getting your benefits up until age 70. The benefit increase no longer applies when you reach age 70, even if you continue to delay taking benefits. Also, keep in mind that if you work and are full retirement age or older, the amount you make at work will not affect your Social Security benefits, no matter how much you earn.

      To help you plan, you can use our online calculators. Also, you can create a personal my Social Security account to verify your earnings, and get a copy of your Social Security Statement. If you are already getting Social Security retirement benefits, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you are not already getting retirement benefits, you should contact us about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65. To learn more about Medicare, visit here. We hope this information helps!

  7. Do I have to renew Extra help for prescription drugs on January each year or it is going to be renewed on the month when I started getting my Social security benefit .
    Will I get a renewal notice in the mail for Extra help ?

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