What is Medicaid?
Many people confuse Medicaid and Medicare. But they’re not the same.
Medicaid Overview & How It Differs from Medicare
Medicaid is a joint federal–state health insurance program that provides coverage for people with low income and limited resources. Unlike Medicare (age/disability-based), Medicaid eligibility is based on financial need and rules vary by state.
Key Features of Medicaid
Comprehensive Coverage
Hospital, doctor visits, preventive services, labs, and in many states, long-term care (nursing home or in-home support).
Low or No Cost
Most enrollees pay little to nothing for covered services; some states charge small copays or premiums.
State-Administered
Funded by federal and state governments but run by states, so eligibility, benefits, and costs vary by where you live.
Medicare vs. Medicaid: Key Differences
| Feature | Medicare | Medicaid |
|---|---|---|
| Who Qualifies | Primarily people 65+, and younger individuals with certain disabilities or conditions (ESRD, ALS). | People of all ages with low income and limited resources (rules vary by state). |
| Type of Program | Federal program – same nationwide. | Joint federal & state – varies by state. |
| Costs | Premiums, deductibles, coinsurance (e.g., Part B premium, Part D drug costs). | Usually low or no cost; some states charge small copays/premiums. |
| What It Covers | Hospital (Part A), medical (Part B), prescriptions (Part D), or Medicare Advantage (Part C). | Comprehensive care, often including hospital, doctor, preventive, prescriptions, and long-term care. |
| Long-Term Care | Limited (short-term skilled nursing/rehab after a hospital stay). | Primary payer of long-term care (nursing homes, in-home assistance). |
| Administration | Run by the federal government. | Run by states within federal guidelines. |
| Can You Have Both? | Yes — “dual eligible” beneficiaries. Medicaid may help pay Medicare premiums and out-of-pocket costs. | Yes — coordinates with Medicare to cover costs/services Medicare doesn’t. |
Have any questions? Ask us anything—we’d love to help.
(615) 908-9037Clear, calm guidance for your financial future.
At Pivotal Financial, our goal is to help you feel confident about the decisions you’re making—whether you’re evaluating retirement income options, rolling over old accounts, or trying to protect what you’ve worked so hard to build.
We’ll walk through your questions in plain language, outline your options, and help you understand how each choice fits your goals. No pressure, no jargon—just straightforward, one-on-one guidance.