Medicaid vs. Medicare

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Alisha John

The main difference between Medicaid and Medicare is that Medicare is primarily available for people who are above 65 or have any other disability. However, Medicaid is available for people who have low-income or other circumstances.

Medicare and Medicaid were established by “President Lyndon B. Johnson” On July 30, 1965. Medicare was basically a health insurance program for aged people. You can get Medicare if your age is sixty-five or above and below sixty-five and have some disability regardless of how low your income is. While Medicaid was established for the people who have low income

What is Medicaid?

Medicaid vs. Medicare

Medicaid is defined as a health care coverage program established for low-income people under age sixty-five and for the people over that age who have depleted their medical benefits. Both states and government-funded jointly to establish this program. It was established in 1965; however, it expanded quickly, and in 1972, the federal government performed various activities to reduce the cost expenditure of this program. But many of the medical staff refused to treat the Medicaid patients because of the low compensation amount involved in the 1980s.

In 2010, the Patient Protection and Affordable Care Act (PPACA) was enacted, which affects Medicare and Medicaid equally.

Advantages of Medicaid

There are the following advantages of Medicaid:

  • In order to provide health facilities to older and disabled persons, Medicaid was established. In the United States, about two-thirds of the medical aid funding has been used by elders and disabled persons.
  • The patient copay costs of those people who are on Medicaid are usually lower and much more inexpensive. It even involves some projects that do not cost any copay or as little as two dollars.
  • Some amount of financial protection is also guaranteed by Medicaid. This program covers many medical expenses, so the people who have a low source of income does not bear many burdens of medical expense because of this program.
  • Privately managed care plans will be offered to the people who are on Medicaid.

Disadvantages of Medicaid

  • Although Medicaid is designed for low-income people, it does not mean that all the people with low income will be able to get this service. Each state has followed specific guidelines in the case of certifying for Medicaid.
  • Medicaid is not very beneficial in case of emergency as the people on Medicaid do not receive proper and necessary treatment just because they are on Medicaid.
  • Medicaid patients may face some discrimination especially older people in a nursing house, and end up receiving unacceptable treatment and have to transfer to another place for care.
  • Some services and treatment also get denied, considered unnecessary because of Medicaid as Medicaid refused to pay for experimental treatment for the patients.

What is Medicare?

Medicaid vs. Medicare

Medicare is a program established to provide help and coverage for people who are below sixty-five and are experiencing low income and with specific disabilities. Some disease selection includes:

  • Lou Gehrig’s Disease (ALS)
  • End-Stage Renal Disease (ESRD)

There are the following programs of Medicare:

  • Hospitalization coverage

It is part A, and it covers the stay in hospitals and especially pays attention to their stay in a nursing facility. It also includes hospice care and some other home health care.

  • Medical insurance

It includes part B, and it covers the doctors’ services, some medical supplies, and other preventive or protective services.

  • Medical advantage plans

It is part C that plays an important role in providing advanced health care facilities to the patients.

  • Prescription drug coverage

It is part D, and it includes covering the expenses of prescription drugs and medicine.

Advantage of Medicare

  • Due to this program, millions of people get an advantage and have been able to get coverage in adult age, and it also supports young people with disabilities.
  • Medicare also play an important role in increasing the standards of the hospitals and other medical facilities as due to this program government gets more involved in the state of the medical facilities
  • Medicare also causes a decrease in the cost of the medicine and drugs and makes them available for the patients.
  • Medicare also costs very little every month, and in return, people get good medical coverage.

Disadvantages of Medicare

  • Due to Medicare, the cost of hospital stays has increased because many people with Medicare claim unnecessary hospital stay cause a burden to hospital facilities.
  • Medicare also causes a strain on the overall healthcare system.
  • Medicare is using a vast number of resources and it is causing a burden on the system as the population is increasing day by day.

Comparison Chart Between Medicaid and Medicare

Basis for comparison Medicare Medicaid
Introduction A federal health care program for individuals who are:

Sixty-five or older than sixty-five

Who has some disability

Or people of any age who have ESDR (End Stage Renal Disorder).

It is a state program joined by the federal responsible for paying for the people and families suffering due to low income and cannot afford medical expenses.
Who governs it? It is governed by the federal government. It is governed by the state government.
Population served People of age 65 or above

Disabled people.

People with low-cost income, including


Pregnant women



What does it cost? It is according to the coverage you choose for yourself; it can vary from person to person. It may include premiums



It is mostly according to the state rules and also your income it may include





Funding fount It includes general revenue and premiums. Federal Match of State Funds (FMAP)


Medicaid and Medicare have helped many individuals since their beginning in the programs undergoing many changes, including some large and small changes. They also undergo many discussions about the project’s budget and different political views about these projects. Many people have benefited from these programs, but they also have some drawbacks. Its cost is rising due to the increase in population, and the government is keen to follow certain strategies to decrease these expenses without affecting the lives of the people.