Medicaid: What’s the Difference?

Medicare and Medicaid are programs that offer government assistance to individuals who need medical assistance. As you think about what health coverage is best for you, Benefits.gov wants to help you understand some of the key differences between Medicare and Medicaid.

Who is eligible?

1. Medicare Center is available to people age 65 and older, or to people under age 65 who have an eligible disability or End-Stage Renal Disease.
2. Medicaid eligibility requirements vary by state and depend on factors such as household income, family size, or disability. Use the Filter by State feature on Benefits.gov to find the Medicaid Program in your state and check if you are eligible.

What is covered?

1. Medicare coverage depends on whether you have Original Medicare or Medicare Advantage. Normally, Original Medicare includes Part A, which covers hospital services, and Part B, which covers doctor services. Medicare Advantage coverage includes Part A, Part B, and usually Part D, which covers prescription drug costs. Visit Medicare.gov to find more information about the services covered by each Medicare plan.
2. According to Medicaid.gov, all states must cover certain services, including inpatient and outpatient services, lab and X-rays, physician services, nursing facility services, and more. States may choose to cover other optional services such as prescription drugs, physical therapy, occupational therapy, and dental services. Find out what services are covered by your Medicaid program by contacting your state Medicaid agency . 

How can I request it?

1. To apply for Medicare, visit the Medicare Benefits on the Social Security Administration website during the open enrollment period, which begins November 1 and ends December 15, and apply online. 
2. You can apply for Medicaid and enroll at any time of the year. Contact your state Medicaid agency for more information or to apply through the Health Insurance Marketplace at healthcare.gov. Find more tips in our most recent article: How to Apply for Medicaid in Your State.

To find more government benefits you may be eligible for, fill out our questionnaire in the Benefit Finder. The Benefit Finder will ask you a series of questions and compare your answers to the eligibility requirements of more than 1,200 government benefits to review your eligibility. While you can’t apply for benefits directly on Benefits.gov, we can help you find information on how to apply and direct you to administrative agencies that can answer your questions.