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Medicaid vs. Medicare: You can have both

Posted: January 17, 2020

Last updated date: December 02, 2022

Medicaid and Medicare. It’s hard to think of two words that cause as much confusion.

  • What is the difference between the Medicare and Medicaid programs?
  • What exactly are Medicaid and Medicare? 
  • Who’s eligible to get Medicaid or to get Medicare? 
  • How can you have Medicare and Medicaid at the same time?

Read on to find out the answers to these questions and more.

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The difference between Medicaid and Medicare

The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.

What is Medicaid?

Medicaid is a way to get health care at a lower cost or sometimes at no cost to you. Medicaid is managed by each state, so the eligibility requirements can change from state to state. Your state may even have its own name for its Medicaid program. It’s important to remember that you have to recertify for Medicaid each year.

Medicaid typically covers:

  • Children
  • Pregnant women
  • Elderly adults and people with disabilities
  • Eligible low-income adults

What is Medicare?

Medicare is a national health insurance program run by the federal government. Medicare covers:

  • People age 65 and older.
  • Some people under age 65 who may qualify due to a disability or another special situation.

Medicare helps millions of American seniors and disabled individuals cover some of their health care costs. There are 4 different parts to Medicare. This helps give people more health care choices, so they can pick the health care plan that best meets their needs.

The 4 parts of Medicare

FYI: Parts A and B are also known as “Original Medicare.”

Part A

Helps pay for hospital stays and inpatient care.

Part B

Helps pay for doctor visits and outpatient care.

Private insurance companies offer other types of Medicare plans with extra benefits that go beyond Original Medicare:

Part C

Combines Part A (hospital insurance) and Part B (medical insurance) in one plan that often includes prescription drug coverage too.

Part D

Prescription drug coverage.

How can you have Medicare and Medicaid at the same time?

Some people qualify for Medicare because of age (they’re age 65 or older) or due to having a disability. They’re also eligible for Medicaid because they meet the requirements to qualify for Medicaid in their state. These people are “dual eligible” because they’re eligible for both Medicaid and Medicare.

What are dual health plans?

Dual health plans are designed just for people who have both Medicaid and Medicare. They’re a special type of Medicare Part C (Medicare Advantage) plan. Dual health plans combine hospital, medical and prescription drug coverage. You’ll keep all your Medicaid benefits. Plus, you could get more benefits than with Original Medicare. And you could get it all with as low as a $0 plan premium.

What are Dual Special Needs Plans (D-SNPs)?

Dual health plans are also known as Dual Special Needs Plans (D-SNPs). They’re offered by private insurance companies, so you can find a dual health plan that best meets your health insurance needs. Being on a dual health plan does not change your Medicaid eligibility or benefits.

See UnitedHealthcare plans in your area

Dual-eligible or Medicaid plan benefits can change depending on where you live. Search using your ZIP code to find the best plan to meet your health care needs.

Still have questions

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Contact us at:
1-844-812-5967 / TTY: 711
8 a.m. to 8 p.m. local time, 7 days a week.

Still have questions

We’re here to help

Contact us at:
1-844-812-5967 / TTY: 711
8 a.m. to 8 p.m. local time, 7 days a week.