Medicare is federal health insurance for people 65 or older and some younger people with disabilities, and most pay a Part B premium of $202.90 a month in 2026; Medicaid is a joint federal and state program for eligible low-income people.
Medicare eligibility is based mainly on age or disability, while Medicaid depends on state rules about income and resources. Some people have both, and they are called dually eligible.
| Question | Medicare | Medicaid |
|---|---|---|
| Who runs it | The federal government, through CMS | Each state, following federal requirements |
| Who qualifies | People 65 or older who meet citizenship or residency requirements; some younger people with a disability, ESRD or ALS | Eligible low-income adults, children, pregnant women, older adults and people with disabilities; rules differ by state |
| What it covers | Hospital Insurance (Part A) and Medical Insurance (Part B) | Can cover services Medicare does not, such as nursing home care and personal care services |
| How it is paid for | Most people pay a Part B premium: $202.90 a month in 2026. About 99% pay no Part A premium | Funded jointly by states and the federal government |
| Where you apply | Social Security | Your State Medical Assistance (Medicaid) office |
Source: CMS (Medicaid, Get Started with Medicare, How to sign up), Medicaid.gov, and CMS 2026 Part B fact sheet
| Program | What it helps pay | Monthly income limit (one person / couple) | Asset limit (one person / couple) |
|---|---|---|---|
| QMB (Medicare Savings Program) | Part A and Part B premiums, deductibles and coinsurance | $1,330 / $1,804 | $9,950 / $14,910 |
| SLMB (Medicare Savings Program) | Part B premium | $1,596 / $2,164 | $9,950 / $14,910 |
| QI-1 (Medicare Savings Program) | Part B premium; funding is limited | $1,796 / $2,435 | $9,950 / $14,910 |
| Long-term care Medicaid (nursing home, home and community-based waiver, hospice) | Long-term care services Medicare does not cover | $2,982 / $5,964 | $2,000 / $3,000 |
Source: Florida DCF, Appendix A-9.1, Financial Standards Effective April 2026 (Medicare Savings Programs) ; Florida DCF, Appendix A-9, SSI-Related Medicaid Financial Eligibility Standards, July 2026 (long-term care)
The Core DifferenceAge-based insurance versus needs-based assistance
Medicare is health insurance you qualify for mainly by age. Medicaid is a program that helps people with limited income and resources, and it is run by each state within federal requirements, so the rules in one state are not the rules in another.
They do not cover the same things. Medicaid can pay for services Medicare does not, such as nursing home care and personal care services.
Having BothWhat happens if you have both
People with both Medicare and Medicaid are called dually eligible. Medicare pays first, and Medicaid pays last, after Medicare and any other insurance you have.
If you have full Medicaid benefits, your state will pay your Medicare Part B monthly premium, and you automatically get Extra Help with drug costs. Depending on your level of eligibility, Medicaid may also pay Medicare cost sharing. Dually eligible people can still choose Original Medicare or a Medicare Advantage plan, and some plans are built for them, such as Special Needs Plans.
Next StepsWhat to do next
To ask about Medicaid, contact your State Medical Assistance (Medicaid) office, because only the state decides eligibility. To enrol in Medicare, we file your Social Security application with you.
In Florida, the Agency for Health Care Administration runs Medicaid and the Department of Children and Families decides who is eligible, except for people who receive Supplemental Security Income, who deal with Social Security. People who are 65 or older, or disabled, apply for what DCF calls SSI-Related Medicaid. You can apply online through ACCESS Florida, by phone at 850-300-4DCF (4323), or in person at a DCF Family Resource Center (DCF Medicaid fact sheet, July 2025). The limits in the second table are DCF's published figures and are updated each year, so confirm the current ones before you rely on them.
Medicare Savings Programs are run by your state, and the CMS guidance is to apply even if you do not think you qualify. If you have Medicare and want to talk through your coverage options, Vivian Soto can compare the plans we offer by phone, video or through the booking calendar.
More QuestionsPeople also ask
Can you have Medicare and Medicaid at the same time?
Yes. People who have both are called dually eligible. Medicare pays first and Medicaid pays last, after Medicare and any other insurance. Vivian Soto, a licensed agent, reviews this with you at no cost: call or text (407) 777-5046.
Does Medicaid pay for nursing home care?
Medicaid offers benefits not normally covered by Medicare, like nursing home care and personal care services. What your state covers depends on its own rules. Vivian Soto, a licensed agent, reviews this with you at no cost: call or text (407) 777-5046.
Who decides if I qualify for Medicaid?
Your state. The rules on who is eligible are different in each state and generally depend on income, resources and other rules such as state residency. Vivian Soto, a licensed agent, reviews this with you at no cost: call or text (407) 777-5046.
This page explains officially published figures. It is not an insurance quote and not an eligibility determination. Only the federal marketplace, Medicare, Social Security or the carrier can determine your eligibility and your actual price.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program.