Medicaid or Medicare are commonly confused or used alternatively. They may seem to be similar, but actually different. These two programs are usually made for different sets of people. But, both have their own set of policies and regulations.

To choose the perfect program for your needs, you must figure out the difference between Medicare & Medicaid.

To provide access to healthcare, the U.S. government created these two programs (Medicare & Medicaid). As per law, Medicaid covers certain medicines that are excluded from Medicare in many states.

What is Medicaid and What it covers?

Medicaid used to provide healthcare service for those who are getting lower income. This is a less or no-cost service.

Medicare Primary Insurance Covers:

Medicare Part- A (In-patient Hospital Services): This includes coverage for hospital visits, hospital care, Nursing facilities and home healthcare services.

Medicare Part-B (Out-patient health services):  This includes the coverage for preventative, diagnostic, medication services based on the health condition.

Medicare Part-C or Medicare Advantage: This is the combination of both Medicare Part-A & Medicare Part- B coverage with additional benefits. Usually marketed by private insurance companies.

Medicare Part-D:  If you have dual eligibility, your medicine will be covered under part-D with Extra Support. 

Medicare Enrollment
Medicare Enrollment

Some example drugs which are covered by Medicaid but not with Medicare:

  • Anorexia, weight gain or loss 
  • Pregnancy 
  • Skin & Hair care 
  • Cold Symptoms 
  • Prescription nutrition and minerals 
  • Non-Prescription medicine 

What is Medicare? 

Medicare covers citizens (Age 65 and over) those who are suffering with chronic conditions and disabilities.

Medicare includes telemedicine support, such as specialist consultation, hospital visits, includes psychotherapy, and some amount of other services.

Medicare only covers telehealth in moderate situation:

  • You travel to a local medical facility which is far away from your home to get telehealth services.
  • You need telehealth services to treat behavioural health conditions. You have the choice to access healthcare from your home or from your health centre.
  • You require telemedicine services to diagnose, estimate, or treat acute stroke.

Can You Have Both the Services?

Dual Eligible – People who are eligible for both Medicaid and Medicare service. You will get the benefits of Medicare Part- A, Part-B, and Part-C & Part D.

Medicare VS Medicaid
Medicare VS Medicaid

Medicaid will also cover other care & drugs which are not covered by Medicare. So dual eligible will cover most of your health care costs. 

Medicaid Advantages 

  • Comprehensive patient base 
  • Helps to get a new practice established 


  • Reduce reimbursements and less revenue 
  • Administrative expenses 

Medicare Advantage 

  • Convenient & alternative covers 
  • Personalized Plan arrangements 
  • Coordinated healthcare 
  • Cost-Saving options


  • Less service providers 
  • Difficult Plan offerings 
  • Extra costs for coverage 
  • State- specific cover 

It is necessary to review healthcare requirements and Medicare options before you select the coverage. Astutedoc will help you.