Paperwork & planning

Insurance basics: Medicare vs. Medicaid

Plain-language overview of what each program is, what it typically covers, and what to ask next.

Quick checklist

  • Medicare is primarily age/disability-based health insurance; coverage depends on Parts A/B/D/Advantage.
  • Medicaid is income/asset-based and often tied to long-term care coverage by state.
  • You can have both (dual eligibility).
  • For long-term caregiving costs, Medicaid rules matter.

What Medicare generally covers

  • Hospital care and limited skilled services under specific rules.
  • Doctor visits and outpatient services.
  • Prescriptions via Part D or Medicare Advantage plans.

What Medicaid often helps with

  • Long-term care supports (varies by state).
  • Home and community-based services (waivers/programs) in many states.
  • Nursing facility coverage when eligible.

Next steps

  • Check the plan card/portal for your loved one’s coverage details.
  • Use your state page to find Medicaid eligibility and local help.
  • If overwhelmed, ask for a benefits counselor or SHIP assistance.