Understanding Medicare and Medicaid: What’s Covered and How to Apply

As we age, health care becomes one of the most critical concerns. Two vital programs designed to support seniors are Medicare and Medicaid, but understanding how each works, what they cover, and how to apply can be confusing. This guide will break down these two programs and provide insight into their eligibility, coverage, and application processes.

What is Medicare?

Medicare is a federal program primarily for individuals aged 65 and older, but it also covers younger individuals with disabilities or specific conditions like end-stage renal disease. 

Different parts of Medicare cover various services:

  • Part A covers hospital care, skilled nursing facility care, hospice care, and some home health care. 
  • Part B covers outpatient services such as doctor visits, preventive services, and certain medical supplies. 
  • Part C (Medicare Advantage) combines Parts A and B and often includes additional benefits such as vision, dental, and prescription drug coverage. 
  • Part D covers prescription drugs. 

Eligibility for Medicare

To qualify for Medicare, individuals must meet the following criteria:

  • Age 65 or older 
  • U.S. citizen or permanent legal resident for at least five years 
  • Younger individuals with qualifying disabilities or conditions 

How to Apply for Medicare

You can apply for Medicare through the Social Security Administration (SSA) website, by phone, or in person at your local SSA office. You can apply up to three months before your 65th birthday.

What is Medicaid?

Medicaid is a joint federal and state program that assists low-income individuals, including seniors, with medical costs. Each state manages its own Medicaid program, which means coverage and eligibility can vary by location. Medicaid provides broader coverage than Medicare, especially for low-income seniors.

What Medicaid Covers

  • Hospital and doctor visits 
  • Prescription drugs 
  • Long-term care, including nursing home care 
  • Home and community-based services 
  • Preventive services and therapies 

Eligibility for Medicaid

Medicaid eligibility is based on income, family size, and other factors. Seniors typically qualify if they meet the income and asset limits in their state. Medicaid is more accessible to individuals with limited financial resources.

How to Apply for Medicaid

To apply for Medicaid, visit your state’s Medicaid website or contact your local Medicaid office. You will need to provide documentation such as income, assets, and personal information to determine eligibility.

 

Key Differences Between Medicare and Medicaid

While both programs help cover healthcare costs, there are distinct differences:

  • Medicare is primarily for seniors aged 65 and older, regardless of income. 
  • Medicaid is designed for low-income individuals and can provide more comprehensive long-term care services. 

Understanding the differences between Medicare and Medicaid is crucial when planning for your healthcare needs in later life. With Medicare focusing on medical care and Medicaid providing long-term care and assistance for low-income seniors, each program plays an important role in supporting health and well-being.

If you or a loved one is navigating Medicare or Medicaid, consider seeking guidance from experts to ensure you are making the best choices for your health care needs.

If you’re ready to learn more about Medicare, Medicaid, or how to apply, visit ElderCareMatters.com America’s National Directory of Elder Care Resources for professional guidance on senior care services. 



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Understanding Medicare and Medicaid: What’s Covered and How to Apply was last modified: September 10th, 2025 by Admin