The Basic Difference Between Medicaid And Medicare.


Medicaid and Medicare are two distinct programmes initiated by the government in 1965 for the help and fulfil the medical needs of the lower-income and older Americans to buy private health insurance.  As both of these programmes are similar in names, therefore most of the people get confused about what the programmes cover and how they work. These two programmes were started by the President Lyndon Johnson. These steps were taken to meet the social, economic, and medical needs of the people.

Although the benefits of these programmes are same, yet there is a sharp difference between these two in several aspects. For example, these are funded and run by different organs of the government and specifically oblige different groups. These programmes are also different with respect to the coverage, range and eligibility requirement. To cut the long story short, Medicare programme was started to help the elderly people with a long-term care, whereas Medicaid covers healthcare costs for the poor, but there is much more to it than this.

In this article, the author will cut through the terminologies and will provide basic comprehension on what each programme covers and exactly who is qualified.


Medicaid is jointly funded by the governments of the states and the federal government. It aims at the help of the low-income families. The federal government provides funds up to 50% of the cost of each state’s Medicaid programme. In this programme, more wealthy states receive fewer funds as compare to the less prosperous states. There are 50 different programmes because of the partnership of the federal and state’s governments.

As for the eligibility for this programme is concerned it has strict criteria. However, these rules vary from state to state. The programme specifically made for the help of the poor, children, pregnant women, caretakers of children, elderly and disabled persons.

Following services are guaranteed by the state and the federal government when they are deemed “medically necessary”:

  • Hospitalization
  • Laboratory services
  • X-rays
  • Doctor services
  • Family planning
  • Nursing facilities
  • Medical and surgical dental facilities
  • Nursing facility services for people aged 21 or older

However, in addition to these, each state has the option to include extra benefits.


Medicare is a federal-funded programme associated with social security. Benefits under this programme are available to all of the citizens of the USA who are 65 years of age or older. Moreover, it also gives benefits to people with certain disabilities. There is no limitation with regard to income. This programme has four parts which are as under.

  1. Hospitalization insurance: It helps pay for inpatient care in a hospital or expert nursing services.
  2. Medical insurance: It helps pay for doctor’s facilities and other medical services.
  3. Medicare Advantage plans: If you have Medicare parts A and B, then you can also join a Medicare Advantage plan. Medicare Advantage plans are offered by the private companies and official Medicare. These plans commonly help you pay the medical expenses not protected by the part A and B.
  4. Prescription drug coverage: It helps pay for medications doctors recommend for treatment.

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Alexis Izquierdo

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The Lawyers at Alexis Izquierdo, P.A. are committed to provide personalized legal representation for all kinds of personal injury cases in Hialeah, Florida.