Confused about Medicare and Medicaid? Learn the key differences, who qualifies, and how dual eligibility (Medi-Medi) can provide full healthcare coverage in 2025.
Medicare vs. Medicaid: What’s the Difference?
Medicare and Medicaid may sound similar, but they are two completely different programs with different eligibility, funding, and benefits.
What is Medicare?
Medicare is a federal health insurance program primarily for:
- People aged 65 and older
- Certain younger individuals with disabilities
It is divided into:
- Part A: Hospital insurance
- Part B: Medical insurance
- Part C: Medicare Advantage
- Part D: Prescription drug coverage
Medicare typically involves monthly premiums, deductibles, and copayments.
What is Medicaid?
Medicaid is a joint federal and state program that provides health coverage for low-income individuals and families, including:
- Children and pregnant women
- Adults with low income
- People with disabilities
- Some seniors who meet income/resource limits
If you're eligible for Medicaid, it may cover:
- Medicare Part A and B premiums
- Deductibles, coinsurance, and copays
- Long-term care, personal care services
- Dental, vision, and more — services Medicare doesn't usually cover
Dual Eligibility (Medi-Medi)
People who qualify for both Medicare and Medicaid are called dual eligibles, also known as Medi-Medi beneficiaries.
If you’re Medi-Medi, most of your healthcare costs are covered, including:
- Hospital stays and doctor visits
- Prescription drugs
- Skilled nursing, home care, and long-term care
- Out-of-pocket costs like copays and deductibles
Being dual eligible gives you access to enhanced benefits with minimal or no cost.
Summary Table: Medicare vs Medicaid
| Category | Medicare | Medicaid |
|---|---|---|
| Administered By | Federal government | Federal + State governments |
| Eligibility | Age 65+, or disabled | Low income + resource limits |
| Costs | Premiums, deductibles, copays | Usually free or very low cost |
| Covers | Hospital, medical, drug | Medicare costs + dental, vision, long-term care |
| Dual Eligibility | Covered by both Medicare and Medicaid | Provides full financial assistance |
Conclusion
Medicare is for seniors and certain disabled individuals, while Medicaid is based on financial need. Some people qualify for both. If you're not sure which applies to you, speak with a Medicare expert or use your state’s Medicaid eligibility tool.
