MEDICARE
What it is: Federal health insurance program
Who gets it: People 65+ OR younger people with qualifying disabilities
Based on: Age or disability status - NOT income
Funding: Federal taxes and premiums you pay
What it covers:
- Hospital care (Part A)
- Doctor visits and medical services (Part B)
- Prescription drugs (Part D, if you choose it)
- Does NOT cover long-term care, most dental, vision, or hearing aids
Costs: You typically pay monthly premiums, deductibles, and coinsurance
MEDICAID
What it is: Federal and state program for people with limited income/assets
Who gets it: Low-income individuals and families of any age
Based on: Income and asset limits - NOT age
Funding: Federal and state taxes - you don't pay premiums
What it covers:
- Hospital and doctor care
- Prescription drugs
- Long-term care (nursing homes, home care)
- More comprehensive benefits than Medicare
- Dental, vision, and other services (varies by state)
Costs: Usually no monthly premiums, very low or no copays
KEY DIFFERENCES:
Eligibility:
- Medicare: Age 65+ or disabled (regardless of income)
- Medicaid: Low income (regardless of age)
Long-term care:
- Medicare: Minimal coverage
- Medicaid: Comprehensive long-term care coverage
Cost to you:
- Medicare: You pay premiums and significant out-of-pocket costs
- Medicaid: Little to no cost
DUAL ELIGIBLE: Some people qualify for both if they're 65+ (or disabled) AND have low income. Medicaid can help pay Medicare premiums and fill coverage gaps.
Simple way to remember:
- Medicare = Health insurance for seniors and the disabled
- Medicaid = Health insurance for people with limited income
