What Is the Difference Between Medicare and Medicaid?

What Is Medicare?

Medicare is a government-run, federally funded health insurance program primarily for people 65 years and older. Medical bills are paid from trust funds that those who are covered have contributed to throughout their lifetimes. It primarily serves people over the age of 65, regardless of income, as well as younger disabled people and dialysis patients. Patients only pay a portion of the costs for hospitalization and other services through deductibles. Non-hospital coverage necessitates the payment of small monthly premiums. Medicare is a federally funded program. It is essentially the same throughout the United States and is managed by the Centers for Medicare & Medicaid Services, a government agency.

What Is Medicaid?

Medicaid is a health insurance program funded by the state and federal government. It assists low-income people of all ages. Patients are usually not required to pay any portion of the costs for covered medical expenses. Sometimes a small co-payment is required. Medicaid is a federal-state partnership program. It differs from one state to the next. It is managed by state and local governments according to federal guidelines. To see if you qualify, visit: https://www.healthcare.gov/medicaid-chip/eligibility/

Who Qualifies for Medicare?

Medicare is usually available to those 65 and older, as well as people under 65 with disabilities. People with End-Stage Renal Disease (permanent kidney failure), are also eligible. Medicare is made up of two parts; Part A (Hospital Insurance) and Part B (Medical Insurance) (Medicare Insurance). If you are 65 or older and have worked and paid Medicare taxes for at least ten years, you are eligible for premium-free Part A. You can get Part A without paying premiums when you reach the age of 65 if you meet the following criteria:

For the past 24 months, you have been eligible for Social Security or Railroad Retirement Board disability benefits. (Please keep in mind that if you have Lou Gehrig’s disease, your Medicare benefits begin the first month you receive disability benefits.)

You require kidney dialysis or a kidney transplant.

While most people do not have to pay a premium for Part A, everyone does if they want Part B. This monthly premium is taken out of your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not receive any of these payments, Medicare will send you a bill every three months for your Part B premium.

Who Qualifies for Medicaid?

Medicaid may qualify you for free or low-cost care based on your income and family size.

Medicaid covers some low-income people, families and children, pregnant women, the elderly, and people with disabilities in all states. In some states, the program is available to all low-income adults earning less than a certain amount.

First, determine whether your state is expanding Medicaid and what this means for you. If your state is expanding Medicaid, you can use this chart to see what you might be eligible for based on your income and family size. Even if you were previously told that you did not qualify for Medicaid, you may now qualify under the new rules.

Sign Up For Medicaid And Medicare In New York State

For more information on Medicaid and Medicare Eligibility in New York, or to sign up, contact the NYS Health Marketplace. 


How do I sign up for Medicare?

To enroll in Medicare or find out if you are eligible, call the Social Security Administration at 1-800-772-1213. You can also go to their website, which is located at www.socialsecurity.gov.

The Medicare.gov website also includes a tool that can help you determine if you are eligible for Medicare and when you can enroll. It’s known as the Medicare Eligibility Tool.

If you already receive Social Security or Railroad Retirement Board benefits, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) beginning the first day of the month you reach the age of 65. There will be no need for you to do anything to enroll.