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The Difference Between Medicare and Medicaid

Do you know the difference between Medicare and Medicaid?

  • Medicare is a federal program that provides health coverage to those age 65 and older, or to those under 65 who have a disability, with no regard to personal income.
  • Medicaid is a combined state and federal program that provides health coverage to those who have an extremely low income, regardless of age.

Did you know you can be eligible for both? Some people may be eligible for both Medicare and Medicaid, known as dually eligible, and can qualify for both programs. The two programs work together to provide health coverage and lower costs, but there are differences in the services they cover.

Medicare is designed primarily to serve people over 65, whatever their income, and younger disabled people and dialysis patients who are diagnosed with end-stage renal disease (permanent kidney failure requiring dialysis or transplant). Patients pay a portion of their medical costs through deductibles for hospital and other services. They also pay small monthly premiums for non-hospital coverage.

According to the Department of Health and Human Services (HHS), patients usually pay none of the costs for covered medical expenses or a small co-payment when they are on Medicaid. Some states cover all low-income adults below a certain income level, HHS says. Since the enactment of the Affordable Care Act, states have been allowed to expand their Medicaid programs to cover all people with household incomes below a certain level. Some states have done so, while others have not.

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