Difference Between Medicare and Medicaid Simple Guide
HSChange Editorial Team
Health Policy Research Team, Consumer Health Guidance
Reviewed by Dr. Sarah Mitchell, MD, MPH, Board-Certified Internal Medicine
Last updated: April 4, 2026
Medicare and Medicaid are both government health programs, and the names are close enough that people mix them up all the time. But they serve different groups of people, are funded differently, and work in completely different ways.
Medicare in a Nutshell
Federal program. Based on age (65+) or disability. About 67 million enrollees. Same benefits nationwide. Funded by payroll taxes, premiums, and federal revenue. You pay premiums ($202.90/month for Part B in 2026), deductibles, and 20% coinsurance. Covers hospital stays, doctor visits, and preventive care. Does not cover dental, vision, hearing, or long-term care.
Medicaid in a Nutshell
Joint federal-state program. Based on income. About 79 million enrollees (including CHIP). Benefits vary by state. Funded by federal and state governments. Little to no cost to enrollees. Covers a broader range of services including dental, vision, long-term care, and transportation in many states. Provider acceptance can be limited due to lower reimbursement rates.
Can You Have Both?
Yes. About 12 million Americans are "dual eligible," meaning they qualify for both programs. For these people, Medicare pays first and Medicaid covers the gaps, including premiums, cost-sharing, and services Medicare doesn't offer. If you think you might qualify for both, contact your state Medicaid office.