Side-by-Side Comparison
| Feature | Medicaid | Medicare |
|---|---|---|
| Eligibility basis | Income and household type | Age (65+) or disability |
| Income requirement | Yes — income-based | No income test |
| Premiums | Usually $0 | Part B: $174.70/mo standard (2026) |
| Dental/vision | Often covered | Very limited (Advantage may add) |
| Long-term care | Covers nursing home care | Very limited |
| Prescriptions | Covered (varies by state) | Part D (separate plan) |
Who Medicaid Serves
Medicaid serves over 80 million Americans across all age groups — children, pregnant women, parents, low-income adults in expansion states, elderly individuals who meet income thresholds, and people with disabilities. Eligibility is primarily income-based. See Medicaid Eligibility by State.
Who Medicare Serves
Medicare is health insurance for people 65 and older, and for certain people under 65 with disabilities or end-stage renal disease. Unlike Medicaid, Medicare is not income-based — you qualify based on age or disability regardless of income. See Medicare Parts A B C D Explained.
Coverage Differences
Medicaid typically covers a broader range of services than Original Medicare at lower cost: dental, vision, hearing, personal care services, and long-term care (nursing home or home health) are generally covered. Original Medicare has significant gaps — no routine dental, vision, or hearing aids, and limited long-term care. Medicare Advantage plans often add dental and vision, but with network restrictions.
Dual Eligibility — Getting Both
Approximately 12 million Americans are "dual eligible" — enrolled in both Medicaid and Medicare. This happens primarily for low-income elderly and disabled individuals. Medicaid "wraps around" Medicare, covering premiums, deductibles, and copays that Medicare leaves unpaid. Medicare Savings Programs (a form of Medicaid assistance) help pay Medicare Part B premiums for low-income Medicare enrollees — see Medicare Savings Programs.
Cost Differences
Medicaid: premiums typically $0, copays $0–$4 for most services. Medicare: Part A is premium-free for most; Part B premium is $174.70/month standard in 2026; Part D drug plan has separate premiums; deductibles and copays apply throughout. Medigap supplemental insurance covers Medicare gaps but adds monthly premium cost.
How to Get Each
Apply for Medicaid at healthcare.gov or your state Medicaid agency. Enroll in Medicare through Social Security at ssa.gov or your local SSA office — enrollment windows matter, especially for Part B and Part D (late enrollment creates permanent penalties). If you might qualify for both, apply for Medicaid first — the dual eligibility and Medicare Savings Program determination is made as part of the process.