Medicare and Medicaid...What's The Difference?

Medicare and Medicaid are both government-run health insurance programs in the U.S., but they serve different groups and are funded differently:
Medicare
- Who it's for: Primarily for people 65 and older, and some younger people with disabilities or end-stage renal
disease.
- Funded by: Federal government, through payroll taxes, premiums, and general revenue.
- Coverage: Includes hospital care (Part A), medical services (Part B), and optional prescription drug coverage (Part D). Private Medicare
Advantage plans (Part C) are also available.
Medicaid
- Who it's for: People of any age with low income, including children, pregnant women, elderly adults, and people with disabilities.
- Funded by: Jointly by federal and state governments. States run their own programs with federal guidelines.
- Coverage: Broader than Medicare in many cases, often including things like long-term care, dental, and vision services.
In short:
- Medicare = Age-based or disability-based, federal program.
- Medicaid = Income-based, state and federal program.
Medicaid is usually low-cost or free, but costs can vary depending on your state, income, and the type of services you use.
Here's a general breakdown:
For Most People
- No monthly premiums
- Very low or no copays
- No deductibles
In Some States
- Higher-income enrollees (still within Medicaid limits) may have:
- Modest monthly premiums (typically under $50)
- Small copays (often $1–$4 per visit or prescriptions
For Long-Term Care (like nursing homes)
- Medicaid may require you to spend down assets or contribute most of your monthly income toward your care, depending on your financial situation.
Special Programs:
- Children (CHIP or Medicaid): Often completely free.
- Pregnant women and people with disabilities: Usually receive coverage with little to no cost.
Engaging in Medicaid planning well in advance can significantly enhance peace of mind for individuals and their families, ensuring they make informed decisions that align with their long-term goals. Legal and financial advice may be needed to effectively manage an individual’s estate. Creating trusts, gifting assets, or employing spend-down strategies are often utilized to align with Medicaid’s requirements. At Rhodes Law, P.A., Ruth will advise you how to qualify, obtain and maintain Medicaid benefits. Call our office at (321) 610-4542 and schedule your consultation today!
You might also like

