Most people know that Medicaid and Medicare are both government funded medical coverage programs to help specific groups of Americans (the elderly and low income individuals). That said, do you know which is which? Do you know what each program actually provides to the group that it has been set up to address? Sometimes you hear something about one of the programs but do you remember which one it applied to? How confident are you the person speaking kept the distinction straight?
This article will provide some quick and easy guidance to clearly understanding the difference when considering Medicaid vs. Medicare.


Medicaid was established to provide low-income individuals with help paying for the costs of medical care and is funded jointly by the federal and state governments. There are strict eligibility requirements and under broad federal guidelines the actual income limits vary from state to state and are often pegged to the Federal Poverty Level (FPL) amount each year. Within the program, however, it is often possible for the children of low-income individuals to be eligible for coverage even if the parents are not.

Unlike Medicare, discussed below, the actual services provided vary significantly from state to state. The Affordable Care Act tried to address this by mandating consistency across the states but this was struck down by the Supreme Court. As such one needs to review the guidance applicable for their state not only for determining eligibility but also what is covered and what costs or deductibles will need to be paid.

With 20% of the population currently on Medicaid the costs of the program are significant, when coupled with Medicare making up 25% of the federal budget. Considering the broad percentage of the population eligible for coverage if you think you may qualify it is worth looking into as a way to minimize your medical costs overall.


Medicare is a purely federal program that is attached to Social Security. Individuals who are 65 years of age or older, as well as those with certain disabilities are eligible to enroll regardless of their income level. The program is broadly broken down into four parts:
  • Part A - Hospital Coverage
  • Part B - Medical Insurance
  • Part C - Supplemental Insurance
  • Part D - Prescription Drug Coverage
Parts A & B are paid for by payroll taxes and deductions from Social Security Income, with Part A costing nothing if you or your spouse paid Medicare taxes for at least 10 years, and Part B having a set monthly cost that is standard across most states. Part C and D are paid for by those that participate in the program, with Part C varying on the supplemental insurance chosen, and Part D being a set monthly cost. Part D was a relatively recent addition to the program in 2006 established to address concerns over rapidly increasing prescription drug costs.

15% of the American population is estimated to be covered by Medicare. Enrollment in Part A & B is automatic for most when they turn 65, and if you think you may be eligible due to disability you can reach out to your local Social Security office to find out.