What’s the Difference Between Medicare and Medicaid?

It’s possible to qualify for Medicare, Medicaid, or both. Here’s a breakdown of eligibility requirements.

Medicare Eligibility

Age-Based Coverage If you are 65 or older and if you (or your spouse) paid Medicare taxes for at least 10 years (or 40 quarters), you automatically qualify for premium-free Medicare Part A. If you or a loved one didn’t pay enough Medicare taxes, you can still enroll, but will pay a premium for Part A.

Medicaid Eligibility

Medicaid is primarily for people who have limited incomes and resources. Currently, Medicaid is the single largest source of health coverage in the United States.

Income-Based Coverage You can qualify for Medicaid if your household income is below a certain amount. This amount varies by state (and is based on other factors, such as household size and disability status), but if your state has expanded Medicaid, you qualify if your household income is below 133 percent of the federal poverty level.

For example, a family of four that has an income of $42,760 or less — which, in 2025, is 133 percent of the federal poverty level — would qualify for Medicaid in states that have expanded the program.

Age and Disability Coverage If you’re on Medicare, you may also qualify for Medicaid if your income and assets are low (meaning you have dual eligibility). That’s because Medicare doesn’t cover all your health insurance costs, so you can qualify for Medicaid on the basis of factors that include your household income and age.

In most states, you also qualify for Medicaid if you receive Supplemental Security Income (SSI), which provides monthly income to people who have disabilities.

It can be harder to qualify for Medicaid if you’re at least 65 years old, though, because Medicaid takes into account your income and assets when determining eligibility.

Medicare Savings Programs (MSPs)