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Medicare vs Medicaid: what is the difference?
Medicare is federal health insurance for people 65 and older, certain younger people with disabilities, and people with ESRD. Medicaid is a joint federal and state program for certain people with limited income and resources, with rules that differ by state. People who have both are called dual eligible.
Facts only, from 3 cited sources, checked October 23, 2026. This page does not recommend either option.
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Medicare vs Medicaid side by side
| Medicare | Medicaid | Source | |
|---|---|---|---|
| Run by | The federal government (CMS) | Federal and state governments jointly | Medicare.gov: Medicaid |
| Who qualifies | 65 and older, certain younger people with disabilities, people with ESRD | Based on the state's income and resource rules | HealthCare.gov glossary: Medicare |
| Rules | National | Different in each state | Medicare.gov: Medicaid |
| Nursing home and personal care | Not normally covered | Offered as benefits Medicare does not normally cover | Medicare.gov: Medicaid |
| When you have both | Pays first for Medicare-covered services | Pays last; the state pays the Part B premium for full-benefit enrollees | Medicare.gov: Medicaid |
| Part B premium, 2026 | $202.90 a month standard | Paid by the state for full-benefit dual eligibles | CMS fact sheet: 2026 Medicare Parts A & B premiums and deductibles |
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What is the difference between Medicare and Medicaid?
Medicare is federal health insurance for people 65 and older, certain younger people with disabilities, and people with ESRD. Medicaid is a joint federal and state program for certain people with limited income and resources, with rules that differ by state. People who have both are called dual eligible.
Can you have Medicare and Medicaid at the same time?
Yes. Medicare.gov calls people with both Medicare and full-benefit Medicaid dually eligible. Medicare pays first and Medicaid pays last.