Medicaid vs. Medicare: What’s the Difference
Medicare and Medicaid are different programs with different eligibility rules. Here’s a clear, side-by-side breakdown of how they differ.
By Boris Sorto, Healthcare Advocate · Updated August 26, 2026
Medicare is a federal health insurance program mainly for people 65 and older (or with certain disabilities), with the same rules nationwide. Medicaid is a joint federal-state program based on income, and its rules vary by state. They’re separate programs, but some people qualify for both.
Side-by-side comparison
| Medicare | Medicaid | |
|---|---|---|
| Run by | Federal government (CMS) | State governments, within federal rules |
| Eligibility basis | Age (65+) or qualifying disability | Income and household size |
| Rules | Same nationwide | Vary by state |
| Typical costs | Premiums, deductibles, coinsurance apply | Little to no cost for most enrollees |
| Long-term custodial care | Generally not covered | Often covers long-term nursing home care |
Can you have both?
Yes. People who qualify for both are called dual eligible, and Medicaid can help cover Medicare’s premiums, deductibles, and coinsurance depending on income level. See our dual eligibility guide for the specific qualifying programs.
Not sure how this applies to your situation? A Medicare Annual Checkup reviews your coverage and flags anything you might be missing, including potential Medicaid or Medicare Savings Program eligibility.
Frequently asked questions
Are Medicare and Medicaid the same program?
No. Medicare is a federal program based on age or disability, run the same way nationwide. Medicaid is a joint federal-state program based on income, with rules that vary by state.
Can I qualify for both Medicare and Medicaid?
Yes. This is called being “dual eligible.” See our guide on who qualifies for both.
Written by Boris Sorto
Bilingual Healthcare Advocate, formerly with Humana’s Medicare operations. More about Boris →