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Understanding the differences between Medicaid and Medicare

Learn about Medicaid, Medicare, and the different eligibility requirements for each.

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Understanding the differences

Medicaid and Medicare are 2 types of public health insurance programs. Learn about the differences in eligibility requirements and available coverage.

Who is eligible?

Medicaid

Generally, Medicaid is a public health insurance plan that provides health insurance for millions of Americans. Coverage is open to people who meet income guidelines, qualified families and children, pregnant women, seniors, and people with disabilities. People of any age can qualify to receive Medicaid benefits.

Often, Medicaid benefits are free or low cost. The Medicaid program is administered (run) by the federal government and individual state governing agencies. Regardless of where you live, Medicaid recipients typically receive the same set of basic benefits.

Many state governing agencies choose to team up with private health insurance companies, like Humana, to support their members with extra benefits and services.

Each state runs its own Medicaid program and decides who is eligible. Some states will cover anyone whose income is below a certain amount. You may need to meet other requirements to qualify for Medicaid in your state.

Find out if you qualify for Medicaid in any of the states where Humana offers Medicaid recipients coverage:

Florida State Enrollment Site (AHCA)

Illinois Gold Plus Integrated

Kentucky State Enrollment Site (kynect)

Ohio Department of Medicaid

South Carolina Healthy Connections

Learn more about Medicaid enrollment and eligibility

Medicare

Medicare is a federal health insurance program open to most people ages 65 and older and to some people under 65 who have specific disabilities.

People eligible for Medicare can get coverage through the federal government or through a private health insurance company like Humana.

Like Medicaid, every Medicare plan is required by law to give the same basic benefits. Private health insurance plans, like Humana’s, often add extra benefits and services for members.

Learn more about Medicare coverage through Humana

What if I’m eligible for Medicaid and Medicare?

You may qualify for Medicaid and Medicare. People who qualify for both health insurance programs are called “dual eligible.”

If you are “dual eligible,” your Medicaid and Medicare plan(s) will work together to give you the best coverage for your needs.

For people with this dual eligibility, Medicare will be your primary plan and cover most healthcare services. Your Medicaid plan will cover services and benefits that Medicare does not.

Learn about Illinois Gold Plus Integrated, a plan for people in Illinois who have dual eligibility