Quick Answer
Medicare is for people 65+ (or with certain disabilities), regardless of income.
Medicaid is for people with limited income, regardless of age.
Medicare and Medicaid are both government health insurance programs, but they serve different populations and work very differently. The similar names cause a lot of confusion—here's how to keep them straight.
Side-by-Side Comparison
| Feature | Medicare | Medicaid |
|---|---|---|
| Who runs it? | Federal government only | Federal + state governments together |
| Who qualifies? | Age 65+, or younger with certain disabilities | Low-income individuals and families of any age |
| Based on income? | No (you qualify by age/disability) | Yes (must meet income limits) |
| Costs to you | Premiums, deductibles, copays | Little to no cost (varies by state) |
| Covers long-term care? | Very limited (short-term skilled nursing only) | Yes, including nursing home care |
| In Florida | Same as all states | More restrictive income limits (no expansion) |
Who Qualifies for Medicare?
Medicare Eligibility Requirements
You're automatically eligible if you:
- Are 65 or older and a U.S. citizen or legal resident for 5+ years
- Are under 65 with a disability and have received Social Security disability for 24 months
- Have End-Stage Renal Disease (ESRD) or ALS at any age
Income doesn't matter for Medicare eligibility—a billionaire and someone with no savings both qualify at 65.
Who Qualifies for Medicaid?
Medicaid Eligibility in Florida
Florida Medicaid covers:
- Children in families with income up to 210% of poverty level
- Pregnant women with income up to 191% of poverty level
- Parents/caretakers with very low income (about 30% of poverty)
- Seniors and disabled who meet income and asset limits
- SSI recipients automatically qualify
Note: Florida has not expanded Medicaid under the ACA, so many low-income adults without children don't qualify.
Can You Have Both? (Dual Eligible)
Yes! About 12 million Americans qualify for both Medicare and Medicaid. This happens when you:
- Are 65+ (qualifying for Medicare) AND have limited income (qualifying for Medicaid)
- Have a disability qualifying for Medicare AND meet Medicaid income requirements
If you're "dual eligible," Medicaid can help pay for:
- Medicare premiums
- Medicare deductibles and copays
- Services Medicare doesn't cover (like long-term care)
Confused About Which Programs You Qualify For?
Our licensed agents can review your situation and explain your options in plain English. No cost, no obligation.
Get Free HelpMedicare Parts Explained
Medicare has multiple parts that cover different services:
- Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing, hospice
- Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services
- Part C (Medicare Advantage): Private plans that combine A, B, and often D
- Part D (Prescription Drug): Covers prescription medications
Learn more about Medicare Parts →
Frequently Asked Questions
I'm turning 65 but still working. Do I need Medicare?
If you have employer coverage, you may be able to delay Part B without penalty. However, you should still sign up for Part A (it's free if you paid Medicare taxes). When your employer coverage ends, you'll have a Special Enrollment Period to sign up.
Does Medicaid cover nursing home care?
Yes, Medicaid is the primary payer for long-term nursing home care in the U.S. Medicare only covers short-term skilled nursing (up to 100 days) following a hospital stay. If you need long-term care, Medicaid is usually the only option unless you have long-term care insurance.
My parent is on Medicare. Can they get Medicaid too?
Possibly. If they have limited income and assets, they may qualify as "dual eligible" and get help with Medicare costs. Even if they don't fully qualify for Medicaid, they might qualify for Medicare Savings Programs that pay premiums and cost-sharing.