Many think that Medicare and Medicaid are interchangeable, but they have distinct purposes and benefits. It’s important to first understand the differences when looking to get healthcare coverage.

Starting with the basics, Medicare is meant for seniors who need help covering medical care, while Medicaid works for a larger group of people with a limited or low income. Each program has different eligibility requirements as well as different benefits, so one may be better suited for your needs than the other.

Medicare is meant for people who have paid into Social Security and are:

  • Age 65 or older
  • Living with certain disabilities under 65
  • Living with certain long-term or terminal disabilities

Depending on the type of Medicare plan that you receive, you can have coverage for

  • Hospital insurance: hospital stays, nursing facility care, hospice, home health care
  • Medical insurance: health care services, outpatient care, home health care, durable medical equipment, preventative services
  • Prescription drugs

Eligibility for Medicaid is based on income and family size. The program typically applies to people who have limited income and are:

  • Age 65 or older
  • Under 19 years old
  • Pregnant
  • Living with a disability
  • Caring for a child
  • Certain adults without dependents

Medicaid covers:

  • Doctors visits
  • Hospital stays
  • Long-term care
  • Preventative care
  • Prenatal and maternity care
  • Mental health care
  • Medications
  • Child vision and dental care

While anyone who receives Social Security is eligible to receive Medicare, Medicaid is restricted to people with lower incomes or other qualifying eligibility requirements. Some people may also be qualified for dual eligibility, meaning that they can receive both Medicare and Medicaid coverage.