Home Senior Medicare vs Medicaid: What’s The Difference Between America’s Major Senior Healthcare Options?

Medicare vs Medicaid: What’s The Difference Between America’s Major Senior Healthcare Options?

by pps-DUEditor

Medicare is a federal program that provides health coverage for those who are 65 and over or irrespective of income and even under 65 if they have a disability. Medicaid, on the other hand, is a state and federal health coverage program for those with very low incomes. Together they hope to provide affordable health care for those who need it most.

While you have a number of coverage options, understanding the differences can save you money in the long run.

Key Differences


  • An age-based program for those who are 65 years and older. Exceptions to the age rule are people with specific medical disabilities or diseases.
  • It is meant for individuals.
  • Might be subject to a penalty if you apply for it outside the open enrollment period. 
  • The basics are standard throughout the country.
  • Plans A and B do not include dental care like tooth extractions, dentures, cleanings, fillings, dental plates, or other dental devices. Under certain special circumstances, Part A might cover dental care in a hospital. 
  • May include only a basic vision test under Medicare Part B coverage. This is usually covered in the preventive initial visit or the annual visit to ascertain ‘wellness’.

Medicaid …

  • An income-based welfare program for those with limited financial resources, regardless of age.
  • Takes into account income, household size, disability, and family status before allowing you to qualify.  
  • Meant to provide low cost and sometimes free health care for individuals or families with limited financial resources, pregnant women, seniors, and people with disabilities.
  • It has no enrollment period so you can apply for Medicaid anytime. Mostly, people qualifying for Medicaid are exempt from the individual penalty.
  • Coverage and eligibility vary from state to state due to the fact that it’s managed both federally and by the state.
  • Offers a basic or mandatory list of benefits that include clinic treatment or hospitalization, doctor services, medical/surgical/dental services, and laboratory/x-ray services. Besides these, the plan also extends to covers family planning and services offered by midwives and more.
  • May cover adult preventative dental care and some treatments in other states.
  • May cover vision care like optometry care, eye exams, or glasses in most states.

You may also like