Differences & Similarities Between Medicare and Medicaid

Differences & Similarities Between Medicare and Medicaid

Government programs like Medicare and Medicaid help individuals get the healthcare they need at more affordable prices. However, it is important to know that these two healthcare programs are vastly different as they offer services to people of different ages. Let’s take a look at the similarities and differences between Medicare and Medicaid.


Medicare is a health insurance program administered by the federal government to cover United States citizens when they reach 65, younger people with disabilities, and those with specific chronic illnesses such as ESRD and ALS. Most people with Medicare paid taxes during their working years and get benefits through Medicare coverage. The Medicare health insurance program has different types of coverage, which include:

  • Medicare Part A (Hospitalization Coverage)
  • Medicare Part B (Medical Insurance)
  • Medicare Part C (Medicare Advantage plans)
  • Medicare Part D (prescription drug coverage)

Those that qualify for Medicare are eligible for premium-free Medicare Part A coverage if they or their spouses paid taxes for at least ten years or 40 quarters. There is a monthly premium required for Medicare Part B coverage.


Medicaid is a federal and state program for low-income individuals and families. Because this program is administered by the state, the procedures and requirements vary across state lines, so you must look to the law in your state for eligibility rules. The federal government provides the guidelines for Medicaid, but each state is tasked with determining how it will be implemented.

Medicaid is usually available to individuals and families with an income that is below 100 percent of the federal poverty level. The Affordable Care Act allows states to increase Medicaid eligibility to up to 138 percent of the federal poverty level. With that, it is easier to qualify for Medicaid in those states. Moreover, you may qualify for Medicaid if your income is below 200 percent and you are elderly, pregnant, a caregiver, or a parent.

In Summary…

These programs are designed to help different populations get access to the care they require. Medicare plans generally cover citizens when they reach 65 and those with disabilities or certain chronic conditions, while Medicaid only covers those with limited income and resources. You can learn more about the differences and similarities between Medicare and Medicaid by contacting Generations Insurance.