Medicare vs. Medicaid

Insurance (Smaller)Extended care for seniors can be very expensive, and often, that heavy burden passes on to loved ones. For example, long-term care costs in Texas can range from $3,000 to $6,000 dollars per month. Fortunately, there are multiple ways to alleviate this burden, two of which are provided through the government. These programs are Medicare and Medicaid. Given the similarity of their names, it can be confusing to distinguish one from the other. There are significant differences between the two however, especially in who they cover and how.



Medicare is specifically designed to provide medical coverage for the elderly. It is funded by the federal government in connection with social security, and offers the following services to seniors over age 65 and to individuals with certain disabilities:

  • Hospitalization coverage: This includes hospital stays, skilled nursing facility (SNF) care, and health home services. However, care in a skilled nursing facility is limited to 100 days, 80 of which require a copay.
  • Medical insurance: This covers medically necessary procedures, needed supplies, and preventative procedures.
  • Prescription drug coverage: This was added as Part D in 2006, and covers part of the cost of your prescription drugs. The copay depends on the drugs needed.

Medicare is most helpful for shorter-term expenses and for covering the cost of prescriptions. However, it is very limited when it comes to long-term care, such as SNF care. Also, Medicare does not cover custodial care, which includes help with walking, bathing, eating, etc. Even so, in spite of these limitations, it can still help out for the short term.


Medicaid differs from Medicare in that it focuses on need rather than age. In order to be eligible, one must have lower income. In addition to the financial limitations, qualification is based on whether you are in any of the following situations:

  • You are pregnant
  • You have a minor living at home
  • You are blind
  • You have a disability
  • Someone in your household has a disability
  • You are age 65 or over

It also differs in that it is jointly funded by the federal government and the state. Because of this, the state determines the coverage offered, though the are some federal requirements.

One of the main things that distinguishes Medicaid from Medicare is the fact that you don’t necessarily have to be elderly to be eligible for Medicaid. Nevertheless, seniors can still benefit from Medicaid, especially since it offers better long-term care coverage, such as help with senior living facility costs. Since extended care can amount to thousands of dollars per month, this can remove a massive burden from your shoulders, but only if you have clear financial need.


In some cases, one can be covered by both Medicare and Medicaid, and there are many benefits for doing so. However, each program has its own requirements, so in order to have both, you must qualify for both individually. One of the major benefits to combining both is that Medicaid can help out with some Medicare costs.

When you are making decisions about senior care, contact Senior Care Centers. Our focus is on high-quality compassionate service, and we offer expert advice on how to best help your loved one get the care he or she needs.

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