No — Medicaid and Medicare are two separate programs with different rules, different funding, and different people they serve

The names sound almost identical, which is why the confusion happens. But Medicaid and Medicare are run by different parts of the government, funded differently, and cover different groups of people. Medicare is federal health insurance tied to age or disability. Medicaid is a joint federal and state program based on income. A person can be on both at the same time — this is called "dual may be able to access" — but being on one does not automatically put you on the other.

The fastest way to tell them apart: Medicare asks "How old are you or are you disabled?" Medicaid asks "How much money do you have?" If you are 65 or older, you are probably may be able to access for Medicare regardless of income. If you are under 65 and have low income, you might be may be able to access for Medicaid, but the income limit depends on which state you live in.

Key Takeaways

  • Medicare is a federal program for people 65 and older, some younger people with disabilities, and people with end-stage renal disease, regardless of income.
  • Medicaid is a state-run program for people with low income; the income limit varies by state and changes year to year.
  • You can be on both programs at the same time if you meet the rules for each one.
  • Medicare has four parts (A, B, C, D) with different costs and coverage; Medicaid coverage varies by state.
  • You must sign up for Medicare by age 65 or face a penalty; Medicaid enrollment is ongoing in most states.

Who Medicare covers and how it works

Medicare is a federal insurance program run by the Centers for Medicare & Medicaid Services (CMS). You become may be able to access at age 65, or earlier if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease or ALS. Income does not matter — a millionaire and a person with no savings are both may be able to access at 65.

Medicare has four parts. Part A covers hospital stays, skilled nursing care, and hospice. Part B covers doctor visits, outpatient care, and some preventive services. Part C (Medicare Advantage) is an alternative way to get Parts A and B through a private insurance company. Part D covers prescription drugs. Most people pay a monthly premium for Part B and Part D; Part A is usually free if you or your spouse paid Medicare taxes for at least 10 years.

You must sign up for Medicare during your initial enrollment period, which starts three months before the month you turn 65 and ends three months after. If you miss this window, you pay a permanent penalty on your premiums for as long as you have Medicare.

Who Medicaid covers and how it works

Medicaid is jointly funded by the federal government and individual states, and each state runs its own program with its own rules. You must have low income to be may be able to access, but the income limit varies. In some states, a single person earning $1,500 a month might may have access to; in others, the limit is higher. Some states also have asset limits — a cap on how much money or property you can own.

Medicaid covers a broader range of services than Medicare in many cases, including dental, vision, hearing aids, and long-term care in nursing homes. But what is covered and how much you pay depends on your state. A service covered in one state might not be covered in another.

Unlike Medicare, there is no age requirement for Medicaid. You can be 25 or 85 and still be may be able to access if your income is low enough. Enrollment is ongoing — you can sign up any time of year, and coverage usually starts the first of the month after you are approved.

When someone is on both Medicare and Medicaid

People who are 65 or older and have low income often may have access to for both. These "dual may be able to access" individuals use Medicare as their primary insurance and Medicaid as a secondary payer. Medicaid covers some costs that Medicare does not, such as long-term nursing home care and some dental work.

If you are dual may be able to access, you still need to sign up for Medicare at 65 — Medicaid does not do this automatically. You also need to be enrolled in Medicaid through your state program. The two programs coordinate with each other, but you have to be on both to get the benefit of both.

How costs differ between the two programs

Medicare has predictable costs nationwide. Part B premiums are the same in every state (though they vary by year and by income level). You also pay a deductible and coinsurance for services. Part D premiums vary by plan and pharmacy, but the structure is the same everywhere.

Medicaid costs vary by state. Some states charge no premiums or copays for low-income people; others charge small amounts. Some states cover more services than others. If you move from one state to another, your Medicaid coverage may change significantly, even if your income stays the same.

Common mistakes people make

The biggest mistake is assuming that being on one program means you are on the other. Many people turn 65, get Medicare, and think they are covered for everything. If their income is low, they may also be may be able to access for Medicaid, which would cover gaps Medicare leaves. But Medicaid does not sign you up automatically — you have to contact your state program.

Another mistake is missing the Medicare enrollment important date. If you turn 65 and do not sign up for Part B within your initial enrollment period, you pay a 10 percent penalty on your Part B premium for life. This penalty stacks if you delay further. There are some exceptions — if you are still working and covered by your employer's health plan, you may have a grace period — but the safest move is to sign up on time.

A third mistake is not checking whether you may have access to for both programs. If you are 65 or older with low income, contact your state Medicaid office to see if you are may be able to access. The extra coverage can save you thousands of dollars a year on long-term care, dental, and other services.

How to find out which program you may have access to for

For Medicare: If you are 65 or older, you are almost certainly may be able to access for Part A. To sign up or check your status, visit Medicare.gov or call 1-800-MEDICARE. You can also visit your local Social Security office. If you are under 65 and have been on SSDI for 24 months, Medicare will contact you automatically.

For Medicaid: Contact your state Medicaid office. You can find it by searching "[your state] Medicaid" or by calling 211, which is a free referral service. Have your income information and proof of residency ready. Medicaid enrollment is ongoing, so you can start the process any time.

If you think you might be may be able to access for both, start with Medicare if you are 65 or older — that is the simpler process. Then contact your state Medicaid office to see if you also may have access to. Many states have programs specifically for people who are dual may be able to access, with extra support and lower out-of-pocket costs.

Frequently Asked Questions

Can I have Medicare and Medicaid at the same time?

Yes. If you are 65 or older and have low income, you can be on both. Medicare is your primary insurance, and Medicaid covers some costs Medicare does not, like long-term nursing home care. You have to sign up for each program separately — being on one does not automatically enroll you in the other.

Do I have to pay for Medicare?

Part A is usually free if you or your spouse paid Medicare taxes for at least 10 years. Part B costs a monthly premium that varies by income; in 2024 it ranges from about $174 to $560 per month depending on your income. Part D (prescription drug coverage) also has a monthly premium that varies by plan.

What if I miss the Medicare sign-up important date?

You pay a permanent penalty on your Part B premium — 10 percent for each year you were may be able to access but did not sign up. This penalty stays with you for life. There are exceptions if you were covered by an employer plan, but the safest approach is to sign up during your initial enrollment period around age 65.

Does Medicaid cover the same things as Medicare?

No. Medicaid covers some things Medicare does not, like dental, vision, hearing aids, and long-term nursing home care. But Medicaid coverage varies by state — a service covered in one state may not be covered in another. Medicare coverage is the same nationwide.

How do I know if I have low enough income for Medicaid?

Income limits vary by state and change each year. The fastest way to find out is to call your state Medicaid office or dial 211 and ask for a Medicaid referral. Have your recent pay stubs or tax return ready. Many states also have online income calculators on their Medicaid websites.