What is the difference between Medicare and Medicaid?

Medicare is mostly about your age. Medicaid is mostly about your income.

Medicare is health insurance run by the federal government. You qualify by being 65 or older, by having received Social Security disability benefits for 24 months, by having ALS, or by having permanent kidney failure. How much money you have does not affect whether you can get it. Medicare works the same way in every state, and it does cost you something — a monthly premium, a yearly deductible, and usually 20% of the cost of outpatient care.

Medicaid is a joint federal and state program for people with limited income. Your state runs it, so the rules and even the name change from state to state — you may know it as Medi-Cal, MassHealth, or TennCare. Medicaid usually costs very little or nothing, and it covers some things Medicare does not, such as long-term nursing home care and rides to appointments.

You can have both at once, which is called being dually eligible. Medicare pays first, and Medicaid helps with what Medicare leaves behind.