Medicaid vs. Medicare — Key Differences
Medicaid is an income-based program for low-income individuals and families, administered by states with federal matching funds. Medicare is a federal health insurance program based on age (65+) or disability status, not income.
Medicaid
Free or low-cost health coverage for low-income individuals and families.
View program →Medicare
Federal health insurance for adults 65+ and some younger disabled individuals.
View program →Can you receive both? Yes.
Approximately 12 million Americans are "dual eligible" — covered by both Medicaid and Medicare simultaneously. Medicare is the primary payer; Medicaid covers premiums, copays, and services Medicare does not include (dental, vision, long-term care). Being dual eligible typically means little or no out-of-pocket cost.
Which should you apply for?
You do not have to choose between them — they serve different purposes and different populations. If you are under 65 and have low income, apply for Medicaid. If you are 65 or older, enroll in Medicare. If you are both low-income and 65+, apply for both and check whether you qualify for a Medicare Savings Program to help with Medicare costs.
Frequently Asked Questions
Does Medicaid cover everything Medicare does?
Medicaid covers more services in many states, including dental, vision, non-emergency transportation, and long-term care that Medicare does not cover. However, Medicaid provider networks can be more limited than Medicare, and not all doctors accept Medicaid. The specific services covered vary by state.
Will I lose Medicaid when I go on Medicare?
Not necessarily. If you are dual eligible — qualifying for both — you keep both coverages. Medicaid acts as a secondary payer filling gaps in Medicare coverage. If your income is above the Medicaid limit but below Medicare Savings Program limits, you may still get help paying Medicare premiums and cost-sharing.
Can I apply for Medicaid if I already have Medicare?
Yes. If your income and resources are low enough, you can apply for Medicaid even while on Medicare. Apply through your state Medicaid agency — not through healthcare.gov. If approved, the dual coverage dramatically reduces your out-of-pocket costs.