Medicaid vs Medicare: Complete Comparison (2026) | Comparison
Medicaid
Joint federal-state health insurance program for low-income individuals, covering 93 million Americans
Low-income individuals, families, pregnant women, children, and people needing long-term care
Quick Answer
AI SummaryMedicare is a federal health insurance program for people 65+ and certain younger individuals with disabilities, funded through payroll taxes. Medicaid is a joint federal-state program for low-income individuals and families, with eligibility and benefits varying by state.
Read full verdictMedicare is age-based (65+) and federally standardized. Medicaid is income-based and state-administered. Some people qualify for both ('dual eligibles'). Medicare covers more seniors; Medicaid covers more total enrollees including children and low-income adults.
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Best pickLow-income individuals, families, pregnant women, children, and people needing long-term care
Choose Medicare if
Americans 65+, people with ESRD or ALS, and certain disabled individuals under 65
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Key Differences at a Glance
- Eligibility:Income-based vs Age-based (65+)
- Premiums:✓ Medicaid wins(Little to none vs $174.70+/month (Part B))
- Long-term Care:✓ Medicaid wins(Covered vs Not covered)
Key Facts & Figures
2 numeric metrics compared
| Metric | Medicaid | Medicare | Ratio |
|---|---|---|---|
| Enrollees | 93 million | 66 million | |
| Annual Federal Spending(USD) | $616 billion | $944 billion |
Sourced from publicly available data ·
Key Differences
6 attributes compared head-to-head
- Income-basedEligibilityAge-based (65+)
- Little to none(winner)Premiums$174.70+/month (Part B)
- Covered(winner)Long-term CareNot covered
- Smaller (state-dependent)Provider NetworkLarge nationwide(winner)
- Any time(winner)EnrollmentAnnual enrollment periods
- State-runAdministrationFederally-run
- Eligibility
Medicaid
Income-based
Medicare
Age-based (65+)
- Premiums
Medicaid
Little to none(winner)
Medicare
$174.70+/month (Part B)
- Long-term Care
Medicaid
Covered(winner)
Medicare
Not covered
- Provider Network
Medicaid
Smaller (state-dependent)
Medicare
Large nationwide(winner)
- Enrollment
Medicaid
Any time(winner)
Medicare
Annual enrollment periods
Full Comparison
| Attribute | Medicaid | Medicare |
|---|---|---|
| Enrollees | 93 million(winner) | 66 million |
| Annual Federal Spending(USD) | $616 billion | $944 billion(winner) |
| Monthly Premium(USD) | $0-$20 (most states)(winner) | $174.70 (Part B standard) |
| Deductible (Hospital)(USD) | $0 in most states | $1,632 per benefit period |
| Covers Dental | Yes (most states) | Limited (Advantage plans only) |
| Covers Long-term Care | Yes | No (custodial) |
| Income Limit | Yes (138% FPL in expansion states) | No income limit |
MedicaidPros & Cons
10 pros·8 cons across both
Medicaid
Pros
Cons
Medicare
Pros
Cons
Frequently Asked Questions
5 questions
Yes. About 12 million Americans are 'dual eligibles' who qualify for both programs. Medicaid can help cover Medicare premiums, deductibles, and services Medicare doesn't cover like long-term care.
In states that expanded Medicaid under the ACA, the limit is 138% of the Federal Poverty Level (about $20,783/year for an individual). Non-expansion states have lower limits that vary significantly.
Medicare covers up to 100 days of skilled nursing facility care after a qualifying hospital stay, but it does NOT cover long-term custodial nursing home care. Medicaid is the primary payer for long-term nursing home stays.
Most people qualify at age 65. You can also qualify under 65 if you have End-Stage Renal Disease (ESRD), ALS, or have received Social Security Disability Insurance (SSDI) for 24 months.
Medicaid covers more total enrollees (93 million vs 66 million) because it includes children, pregnant women, and low-income adults. Medicare spending is higher because per-beneficiary costs are greater for the older population.
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