What is the difference between Medicare and Medicaid?

Who is each program for?

Medicare is health insurance for people who are 65 or older and who meet the citizenship or residency rules. Medicare.gov says younger people can also qualify if they have a disability, permanent kidney failure or ALS. Your age or health condition decides if you can get it, and your income is not part of the test.

Medicaid follows a different rule than Medicare does. Medicare.gov calls it a joint program of the federal government and the states that helps certain people with low incomes pay for medical costs. Medicaid.gov says it serves eligible adults with low incomes, children and pregnant people. It also serves older adults and people with disabilities. Whether you qualify depends on your income, the size of your household and the state where you live.

A simple way to remember it is that Medicare follows your age or disability, while Medicaid follows your income. A person can fit both descriptions, and that is why the two programs get mixed up so often.

Who runs each program and who pays for it

The federal government runs Medicare, and the rules are the same in every state. The agency in charge is the Centers for Medicare and Medicaid Services, which most people call CMS.

Each state runs its own Medicaid program under federal rules. Medicaid.gov says states administer it by following federal requirements, and that states and the federal government pay for it together. Each state makes many of its own choices. The name, the income limits and some of the benefits can change when you cross a state line.

The money comes from different places as well. Medicare's trustees say Part A, the hospital part, is paid for mostly by a payroll tax. Workers pay 1.45 percent of their wages into it, and so do employers. The other parts of Medicare are paid for by premiums, plus money from the federal government. A premium is the amount you pay each month to keep coverage. Medicaid is paid for by tax money from your state and from the federal government.

What each program costs you

Most people pay something for Medicare, and Medicare.gov lists these 2026 amounts for Original Medicare.

• Most people pay no monthly premium for Part A, which covers hospital stays. It is free when you or your spouse worked about 10 years and paid Medicare taxes.
• The standard premium for Part B, which covers doctor visits and outpatient care, is $202.90 a month in 2026. It can be higher for people with higher incomes.
• Part B also has a yearly deductible of $283 in 2026. A deductible is the amount you pay before Medicare starts to share the cost.
• The Part A deductible is $1,736 for each benefit period in 2026. A benefit period starts when you enter a hospital and ends after you have been out of care for a set time.

Medicaid usually costs you little or nothing. According to HealthCare.gov, coverage through Medicaid and CHIP costs little or nothing. Some states charge a small copayment, which is a small fee you pay at the visit, for certain services. Your state agency can tell you if any fees apply to you.

What each program covers

According to Medicaid.gov, Medicare has four basic forms of coverage. Part A pays for hospital costs, while Part B pays for doctor visits and outpatient care. Part B pays for medical equipment too, which Medicaid.gov counts in the same group. Part C is a Medicare Advantage plan, which is a private plan that Medicare approves. Part D helps with the cost of prescription drugs.

Long-term care is not something Medicare pays for. Medicare.gov says custodial care, which means everyday help such as bathing and dressing, is not covered if it is the only care you need. Medicare will pay for a short stay in a skilled nursing facility after a hospital stay. A nursing home that you live in for years falls outside that coverage.

Every state must provide a set list of Medicaid benefits. Medicaid.gov names hospital care, doctor visits, home health services, nursing facility services and rides to medical care. Children also get a full set of checkups and treatment called EPSDT. Other benefits are optional for states, such as adult dental care and eyeglasses.

Our guide on Medicaid nursing home coverage explains the long-term care part in more detail.

Many people have both Medicare and Medicaid

Medicare.gov calls someone with Medicare and full Medicaid coverage dually eligible. Medicare pays first for the services it covers. Medicaid pays last, so it can fill in some of what Medicare leaves behind.

A state may also pay your Part B premium, according to Medicare.gov. Depending on your level of coverage, it may pay some of your other Medicare costs too. People with full Medicaid get Extra Help with drug costs automatically. They are also signed up for a Medicare drug plan if they do not have one.

Some people do not qualify for full Medicaid but still get help with Medicare costs. Those state programs are called Medicare Savings Programs. Our Medicare Savings Programs guide explains them with the 2026 limits.

How you apply for Medicare

The Social Security Administration handles Medicare sign-ups, and you can sign up online on its website. You can also call 1-800-772-1213, Monday through Friday, from 8 in the morning to 7 at night in most time zones. People who are deaf or hard of hearing can use the TTY number, 1-800-325-0778.

Some people get Medicare automatically, and others have to sign up. People who get Social Security benefits before they turn 65 are usually signed up automatically. Anyone else should plan ahead for the Initial Enrollment Period, which is your first chance to sign up. It lasts 7 months, starting 3 months before you turn 65 and ending 3 months after the month you turn 65. If you miss it, you may have to wait and pay a late penalty for Part B.

For questions, 1-800-MEDICARE (1-800-633-4227) is open 24 hours a day, 7 days a week, except some federal holidays.

How to apply for Medicaid

Your state agency takes Medicaid applications, and you can use your state Medicaid agency or the application on HealthCare.gov. You can apply at any time of year. Our how to apply for Medicaid guide walks through the papers and the steps, and our Medicaid eligibility guide explains who qualifies.

The rules for who qualifies are set state by state, so check your own state's Medicaid site for its income limits. If you are not sure where you stand, apply anyway. HealthCare.gov and Medicare.gov both say you should apply even when you think you may not qualify.

If you do not have either program, you still have choices. A community health center charges based on income, and you can search for a cash-pay doctor near you. This page is general information and not medical advice. If you think you are having an emergency, call 911 or go to the nearest emergency room.