Medicare vs Medicaid: what's the difference?
Similar names, different programs, and some people qualify for both.
Medicare and Medicaid were created by the same 1965 law and are easy to confuse. Medicare is federal health insurance based mainly on age or disability. Medicaid is a joint federal and state program for people with limited income and resources.
The key differences
| Term | Whole life | |
|---|---|---|
| Who qualifies | People 65+, and some younger people with a disability, ALS or ESRD | People with limited income and resources; rules vary by state |
| Who runs it | The federal government (CMS), with private plans for Parts C and D | Each state, within federal rules |
| Costs to you | Premiums, deductibles and coinsurance | Little or nothing for covered care |
| Long-term care | Doesn't cover long-term custodial care | The main public payer for long-term nursing home care |
| Name | Medicare, nationwide | Varies by state (for example Medi-Cal in California, MassHealth in Massachusetts) |
Having both: dual eligibility
Many people with Medicare also qualify for some Medicaid help. If you have both, Medicare pays first and Medicaid can pay premiums, cost sharing and services Medicare doesn't cover, such as long-term care. You also get Extra Help with drug costs automatically.
Some people qualify only for a Medicare Savings Program, which uses Medicaid funding to pay Medicare premiums and sometimes cost sharing, without full Medicaid benefits.
Applying
You apply for Medicaid and the Medicare Savings Programs through your state's Medicaid agency, not Social Security. Income and resource limits differ by state and program, so it's worth applying even if you think you're just over the limit. Your state's SHIP can help, for free.
Common questions
Yes. People who qualify for both are called dual eligible. Medicare pays first, and Medicaid helps with costs and services Medicare doesn't cover.
If you qualify for full Medicaid or a Medicare Savings Program, your state usually pays your Part B premium, and sometimes your Part A premium and cost sharing.
Yes. Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for people with Medicare and Medicaid. Whether one is right for you depends on your doctors, drugs and state.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Medicare Savings Programs, Medicare.gov. Checked September 29, 2026.
- Help with drug costs, Medicare.gov. Checked September 29, 2026.
- Long-term care, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.