Medicare vs. Medicaid: Understanding the Difference
Medicare
Who it’s for:
What it covers:
What it covers:
- People 65 and older
- People under 65 with certain disabilities
- People with End-Stage Renal Disease (ESRD) or ALS
What it covers:
What it covers:
What it covers:
- Part A: Hospital insurance (inpatient, skilled nursing, hospice, some home health)
- Part B: Medical insurance (doctor visits, outpatient care, preventive services, durable medical equipment)
- Part C (Medicare Advantage): Combines Parts A & B, often includes drug coverage and extra benefits
- Part D: Prescription drug coverage
Costs:
How to apply:
How to apply:
- Premiums, deductibles, and copayments vary by plan.
- Usually does not cover long-term custodial care.
How to apply:
How to apply:
How to apply:
MedicAID
Who it’s for:
What it covers:
What it covers:
- Individuals and families with low income or limited resources
- Covers children, pregnant women, adults, seniors, and people with disabilities
What it covers:
What it covers:
What it covers:
- Hospital and medical services
- Long-term care services (nursing homes, assisted living, home and community-based care)
- Prescription drugs
- Preventive and behavioral health care
Costs:
How to apply in Maryland:
How to apply in Maryland:
- Little to no cost depending on income and state rules
- Administered by the state, so coverage varies
How to apply in Maryland:
How to apply in Maryland:
How to apply in Maryland:
Call 1-855-642-8572 or visit your local Department of Social Services
Dual Eligibility
Some individuals qualify for both Medicare and Medicaid, often called “dual eligible.”
- Medicare pays first; Medicaid may cover premiums, copays, and additional services that Medicare doesn’t.
- This is especially important for seniors in assisted living or with chronic conditions.
What’s New in 2025
As 2025 brings big policy changes, it's more important than ever to understand the difference:
- Medicare is a federal program for adults 65+ and people with certain disabilities—now with capped out-of-pocket drug costs and upcoming physician payment changes.
- Medicaid is a state-managed program for low-income individuals—recent updates include work requirements, co-pays, and eligibility redetermination.
Stay informed. These changes may affect your access to care or services.
Helpful Resources
Medicare Resources
Official Medicare Website
State Health Insurance Assistance Program (SHIP)
Official Medicare Website
- Check eligibility and enroll
- Compare plans (Parts A, B, C, D)
- Find providers and costs
Medicare & You Handbook
State Health Insurance Assistance Program (SHIP)
Official Medicare Website
State Health Insurance Assistance Program (SHIP)
State Health Insurance Assistance Program (SHIP)
State Health Insurance Assistance Program (SHIP)
Free local counseling for Medicare recipients
CALL: 1-800-243-3425
Medicaid Resources
MedicaID Website
Maryland Medicaid Program
Maryland Medicaid Program
- Policy updates, federal guidance, eligibility basics
- Provider enrollment and billing info
Maryland Medicaid Program
Maryland Medicaid Program
Maryland Medicaid Program
- Apply for services
- Find managed care organizations
- Long-term services and supports (LTSS)
Additional Support
Social Security Administration
Social Security Administration
Social Security Administration
Medicare enrollment for people turning 65 or disabled
Benefits-CheckUp
Social Security Administration
Social Security Administration
Find benefits programs for older adults
Contact us
Understanding which program is right for you can be confusing—AIBS Care can help!
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