Difference Between Medicare and Medicaid

Medicare has four basic categories covering various overheads. The broad categories are hospitalization, necessary medical services, prescription drugs, and supplementary coverage.

On the other hand, Medicaid assists in health care facilities for lower-income groups. It assists millions of citizens.

People with disabilities, children, and adults avail the services. It covers the cost of nursing facilities for those who have no means of paying for it.

Comparison Table Between Medicare and Medicaid

Parameter of ComparisonMedicareMedicaid
MeaningIt is a Federal Insurance program.It is a state and federal program to assist lower-income groups.
Criteria65 years and above, and younger people get the facilities based on specific disabilities.There are no age criteria. It is based on income.  
CostsThe citizens pay part of the cost through deductibles. Medicare requires a small number of monthly premiums.They may or may not pay for the expenses incurred. A small fee is paid at the time of enrollment.
CoverageMedicare is divided into various parts to cover different aspects of health care.The benefits vary in every state. Some basic expenses are covered by all states.
Administered ByThe federal government forms uniform rules for Medicare at a national level.The state manages its own Medicaid program.

What is Medicare?

A national health insurance program that began in 1965 is Medicare. It is a program in the United States which was part of the Social Security Act.

There are few definite eligibility criteria for Medicare. Anyone legally living in the United States for more than five years and is aged 65 or above qualify for Medicare.

Four different Medicare programs are available to citizens. Broadly it is divided into Part A, Part B, Part C, and Part D. Basic coverage primarily is covered in Part A and B.

Let us briefly understand each of these divisions:

Medicare Part A:

It covers the regular billings by the hospital or similar in-patient settings. It can even get utilized in nursing facilities or home-based healthcare. It does not cover long-term costs.

Medicare Part B:

It takes care of the outpatient cover cost. Doctor’s visit, Ambulance charges, and specific medical equipment are taken into consideration.

Medicare Part C:

This plan is also named Medicare Advantage. It can get purchased through private insurers. They could include insurance even while traveling out of the States.

Medicare Part D:

This plan is for supplementary prescription drug coverage. Many in the primary inclusion opt for Part D to receive subsidies for prescription drugs.

What is Medicaid?

This healthcare program is designed to help in the healthcare costs for people with limited income and resources. This venture in the United States is both a federal and state program.

It includes intricate and even ensures the expensive medical needs of the citizens. Let us now discuss the basic features of Medicaid:

  1. Medicaid beneficiaries are blessed with better medical access. Deferral of medical care or living with medical issues due to monetary constraints is now history.
  2. Senior citizens or people with disabilities are the significant recipients of Medicaid in comparison to children or adults.  

Main Differences Between Medicare and Medicaid

  1. The medical coverage of the schemes is very distinctive. Medicare is divided into basic-four parts, covers different phases of healthcare. The Medicaid benefits vary state-wise.
  2. Both the program is funded and governed in different methods. Medicare is a federal insurance program. The bills paid are through the funds, and insurers finance them.
Difference Between Medicare and Medicaid


Both Medicare and Medicaid are available to the elderly, disabled, adults, and children. They are even at hand to low-income individuals and families.

It aims to offer better health care facilities for the citizens. The individual availing the facilities has a right to quality care and feels secure while receiving the care.

Medicare and Medicaid are considered the most efficient and well-managed health insurance in the world. They strive to enhance their performance to create a world-class health care system.


  1. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2009.0494
  2. https://pubmed.ncbi.nlm.nih.gov/20677415/
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