Medicare and Medicaid Eligibility Requirements: Who Qualifies?

Medicare is a federal health insurance program for people who are 65 years or older, younger people with disabilities, and people with end-stage renal disease.

Medicaid is a joint federal and state program that helps with healthcare costs for people with limited income and resources. Each state has its own eligibility rules and coverage options.

People who are 65 years or older, younger people with disabilities, and people with end-stage renal disease are eligible for Medicare. Most people are automatically enrolled in Medicare when they turn 65 if they are receiving Social Security benefits.

Eligibility for Medicaid varies by state, but generally, people who have limited income and resources are eligible. This includes pregnant women, children, parents, seniors, and people with disabilities. Some states have expanded Medicaid to cover more people.

Income limits for Medicaid vary by state and household size. In general, you may be eligible if your income is at or below 138% of the federal poverty level. Some states have higher income limits for certain groups, like children or pregnant women.

Medicare covers many healthcare services, including hospital stays, doctor visits, preventive care, and prescription drugs. However, there are some services that are not covered, like long-term care and most dental care.

Medicaid covers a wide range of healthcare services, including doctor visits, hospital stays, lab tests, and prescription drugs. Some states also cover additional services, like dental and vision care. Medicaid may also cover long-term care in a nursing home or at home.