| Medicare | Medigap | Medicaid | |
| What is it? | Federal health insurance program for those age 65 or older or younger people who have certain health conditions. Parts A and B comprise the original Medicare program. Medicare Advantage (also referred to as Part C) plans are also available in most areas. They provide managed care and fee-for-service options through private insurers that contract with Medicare. | Medicare supplement insurance issued by private companies. | Joint federal-state need-based health insurance program. Eligibility requirements and covered services vary from state to state. |
| What does it cover? | All or some portion of: Part A: Hospital and skilled nursing facilities, home health agency care, hospice care, inpatient psychiatric care, and blood transfusions. Part B: Doctors, outpatient mental health services, therapy, part-time skilled home health care, certain preventative services, and other medical services. Part C: All the benefits offered by the original Medicare plan. Some offer added benefits such as dental care, eye exams, and hearing aids. Most offer Prescription drug (Part D) coverage. Part D: Prescription drug coverage (optional). | All or some portion of: Medical care not covered by Medicare, deductibles, co-payments, and coinsurance; plans may also cover other services such as eye and dental exams. | All or some portion of: A broad range of medical services including inpatient and outpatient hospital care, prescription drugs, nursing home care, and skilled care. |
| Who is eligible? | Generally, persons age 65 or older, and those with certain disabilities or diseases are eligible for Medicare Parts A and B. Anyone eligible for Parts A and B is eligible for Part C and Part D. | Individuals who are enrolled in Medicare Parts A and B. Those enrolled in Medicare Part C don't need (and can't enroll in) Medigap. | Individuals who have limited income and resources and who meet other eligibility requirements. |
| What is the premium cost in 2023? | Part A: Most beneficiaries don't pay for this coverage because of prior Social Security covered employment. Part B: Standard premium is $164.90 People with higher incomes may pay a higher premium, while some people will pay less than the standard premium. Part C: Varies by insurer, state, and plan. Part D: Varies by insurer, state, and plan. | Premiums vary by company, region, and plan. There are generally 8 available plans, each offering different levels of coverage. Not all plans are available in every state. | No premium. |
| What does it take to enroll? | If you've been receiving Social Security or Railroad Retirement Board benefits for at least four months before you turn 65, you will be automatically enrolled in Part A and Part B. Otherwise, you will need to enroll in Medicare through the Social Security Administration by applying online, by mail, or in person. | Purchase a policy from an insurance company. You can find information on Medigap policies offered in your area by visiting the Medicare website or calling (800) 633-4227. | Application procedures vary from state to state. For information, contact the agency responsible for administering Medicaid in your state. |
Medicare, Medigap, and Medicaid
July 01, 2023