Despite their similar names, Medicare and Medicaid are completely different programs. Confusing the two costs people thousands of dollars every year. Here's exactly how they differ in 2026.
Quick Definitions
- Medicare = federal health insurance for people age 65+ (or under 65 with certain disabilities). Funded by payroll taxes. Available regardless of income.
- Medicaid = joint federal-state health insurance for people with low income. Funded by federal + state funds. Eligibility depends on your income, not age.
Side-by-Side Comparison
| Feature | Medicare | Medicaid |
|---|---|---|
| Who qualifies | Age 65+ (or disabled) | Low income (varies by state) |
| Income limit | No income limit | ~138% FPL in expansion states ($20,120 single) |
| Cost to enrollee | Premiums + deductibles + copays | $0 or very low |
| Where to enroll | Medicare.gov or SSA | Your state's Medicaid office |
| Enrollment period | 3 months before/after 65th birthday | Year-round, anytime |
| Long-term care | Limited (100 days max) | Comprehensive (nursing homes covered) |
Can You Have Both Medicare and Medicaid?
Yes. About 12 million Americans are "dual-eligible" — they qualify for Medicare (because of age) AND Medicaid (because of low income). Medicare covers most healthcare costs, and Medicaid picks up Medicare's premiums, deductibles, and services Medicare doesn't cover (like long-term care). This combination is incredibly valuable.
Medicare Basics: The 4 Parts
- Part A (Hospital): Inpatient stays, skilled nursing. Free for most people.
- Part B (Medical): Doctor visits, outpatient care. ~$185/month in 2026.
- Part C (Medicare Advantage): Private plans that bundle A + B + often D. Many $0 premium.
- Part D (Prescriptions): Drug coverage. ~$35/month average.
Medicaid Basics
Medicaid covers a comprehensive range of services in every state: doctor visits, hospital stays, prescriptions, mental health care, pregnancy and maternity care, nursing home care, and more. Some states cover dental and vision; others don't. Your state's program may have a different name (Medi-Cal in California, MassHealth in Massachusetts, BadgerCare in Wisconsin).
How to Tell Which You Should Apply For
- Are you 65 or older? → Apply for Medicare. Apply 3 months before your 65th birthday.
- Are you under 65 with low income? → Apply for Medicaid (or screen for ACA marketplace + subsidies).
- Are you disabled? → You may qualify for Medicare after 24 months on SSDI, OR for Medicaid based on income.
- Are you 65+ AND low income? → Apply for both. You're likely dual-eligible.
Not sure which applies to you? Our licensed agents can screen you for both Medicare and Medicaid eligibility for free. Get screened in 60 seconds →