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Medicare vs. Medicaid
What is the difference between Medicare and Medicaid?
Medicare is a federal health insurance program open to Americans aged 65 and older.
Medicaid is a state-specific insurance program for low income individuals with limited financial assets.
Medicaid is a state-specific insurance program for low income individuals with limited financial assets.
What are Medicare’s Benefits vs. Medicaid’s Benefits?
In the context of long term care for the elderly, Medicare’s benefits are very limited. Medicare does not pay for personal care (also known as custodial care or non-medical care). Medicare will pay for a very limited number of days of skilled nursing (also referred to as nursing home care). Medicare will also pay for some home health care provided it is medical in nature.
Medicaid, being state run, has different benefits in each state. Generally speaking, Medicaid pays for nursing home care and through waiver programs; Medicaid pays for home care, personal care and assisted living. To avoid confusion, it is worth noting that Medicaid is referred to by different names in different states. For example in California it is called Medi-Cal.
Medicaid, being state run, has different benefits in each state. Generally speaking, Medicaid pays for nursing home care and through waiver programs; Medicaid pays for home care, personal care and assisted living. To avoid confusion, it is worth noting that Medicaid is referred to by different names in different states. For example in California it is called Medi-Cal.
What are Medicare’s eligibility requirements compared to Medicaid’s?
| Eligibility in 2012 | Medicare | Medicaid |
| Age Limit | 65 and older | No age limit |
| Income Limit | No income limit | Approximately $2,094 / month* |
| Asset Limit | No asset limit | Approximately $2,000 |
| Health Restrictions | None | Some depending on program / waiver |
*Some states have "spend-down" Medicaid in which income limits are considered relative to care costs.
Can someone be eligible for both Medicare and Medicaid?
Yes, these are not mutually exclusive programs. These persons are referred to as having Dual Eligibility, Dual Eligibles or often simply “Duals”. Typically, Medicaid will pay for their Medicare premiums and co-payments. There are also programs referred to as Medicare Saving Programs for low income individuals who don’t quite qualify for Medicaid.
Use our Eldercare Financial Resource Locator Tool to find public and private programs that can help pay for or reduce the costs of long term care for the elderly.
Use our Eldercare Financial Resource Locator Tool to find public and private programs that can help pay for or reduce the costs of long term care for the elderly.
