Differences Between Medicare and Medicaid

Older couple portrait

As individuals near retirement, one of many questions they will ask themselves is how to pay for medical care. Two of the most common options are Medicare and Medicaid. While some may believe they can choose between either program, that’s not always an option.

Basics of Medicare

Medicare is the federal program that provides health coverage for individuals older than 65 or under 65 with a disability — no matter that person’s income. There are four parts to Medicare:

  • Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.
  • Part C is an option for those receiving Part A and Part B benefits through a private health plan.
  • Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans.

If individuals are not automatically enrolled in Medicare when they become eligible, they will need to sign up during their Initial Enrollment Period.

Basics of Medicaid

Medicaid is a state and federal program that helps with medical costs for individuals with limited income and assets. Medicaid programs typically cover long-term care that Medicare doesn't cover.


One big difference between Medicare and Medicaid is that Medicaid is means-tested and Medicare is not. This means that only certain people with a very small amount of savings can qualify for Medicaid. Another very important difference is that Medicaid covers long-term care costs (nursing home or assisted living), but Medicare does not cover these costs except for a maximum of 100 days, and only if certain conditions are met.

How Can I Qualify for Medicaid?

One benefit of working with an established elder law attorney is that with the proper planning, an individual may qualify for Medicaid to pay for nursing or assisted living while keeping much of their wealth in the family. Dan Krause can help you review the options available so that your hard-earned money can stay where it belongs and be used how you want it to be.

Contact Krause Estate Planning to see what Dan can do for you. (608) 344-5491

Related Posts
  • Can I Be Enrolled in Medicaid and Medicare at the Same Time? Read More
  • How the Medicaid Spend Down Works Read More
  • Most Common Questions About Medicaid Read More