Medicare V Medicaid

Medicare vs Medicaid: Coverage Options for Older Adults

Feature	Medicare	Medicaid
Who it serves	Primarily people age 65+ and some younger people with qualifying disabilities or certain illnesses.	Low-income individuals and families; many states also cover older adults, people with disabilities, and other qualifying groups.
Who runs it	Federal program with uniform national rules.	Joint federal–state program; each state sets eligibility and many benefit details within federal guidelines.
Main coverage	Hospital care, doctor visits, preventive care, and prescription drugs through different parts (A, B, C, D).	Comprehensive medical coverage that often includes hospital care, doctor visits, prescriptions, and in many states long-term services and supports.
Prescription drugs	Usually covered through Part D or some Medicare Advantage plans; plans vary by cost and formulary.	Typically covered, but specific rules, co-pays, and preferred drug lists vary by state.
Long-term care	Very limited; generally does not cover custodial long-term care in nursing homes or at home.	Major payer for nursing home care and home- and community-based services for eligible people; rules vary by state.
Home health care	Covers some medically necessary home health services under specific conditions.	Can cover home health and other in-home support services, depending on eligibility and state program design.
Out-of-pocket costs	Can include premiums, deductibles, and coinsurance; amounts vary by part and plan.	Usually low or no premiums, with small co-pays in some cases; many beneficiaries pay little or nothing.
Dual coverage	Some people qualify for both; Medicaid can help pay Medicare premiums and cost sharing.	Same as left; “dual eligibles” often have Medicare as primary and Medicaid as secondary payer.

Note: This chart summarizes general features; specific benefits, eligibility rules, and costs vary by state and individual circumstances.