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Medicare and Medicaid. What is the Difference?

It may be easy to confuse Medicare vs Medicaid because they are both health insurance programs sponsored by the government. However, the benefits and eligibility requirements are different for Medicare vs. Medicaid. In some cases, you may be eligible for both, which is called “dual eligible.”


How do I qualify for Medicare vs Medicaid?

Medicare is for U.S. citizens and permanent legal residents of at least five years who are either:

  • 65 or older

  • Disabled under certain conditions or with certain medical conditions

You can qualify for Medicare through disability if you:

  • Have received at least 2 years (24 months) of Social Security disability benefits or a disability pension from the Rail Road Retirement Board (RRB).

  • You have end-stage renal disease (ESRD) and need routine dialysis or a kidney transplant.

  • You have Lou Gehrig’s disease. (If you have Lou Gehrig’s disease there is no waiting period to get Medicare benefits after you start getting disability benefits)

One way to qualify for Medicaid is through income. Unlike Medicare, you don’t necessarily have to be a certain age or have a disability to qualify for Medicaid. According to healthcare.gov, some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. The exact income you have to have to qualify for Medicaid varies by state. Some states may have more Medicaid coverage for families with children, women who are pregnant, and people who have disabilities.


Coverage: Medicare vs Medicaid


Some Medicaid benefits may overlap with Medicare, but Medicaid may also cover services that Medicare doesn’t.


When you compare Medicare vs. Medicaid, Medicaid potentially offers more benefits.

If you would like to know more on how to sign up for these programs. Please contact us at (860) 852-3610 and one of our brokers will help you maximize your benefit's.

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