Medicare and Medicaid have different disability eligibility criteria, coverage, and costs. That said, it may be possible to qualify for both programs, which may offer extra benefits or lower your costs.

Medicare and Medicaid are both government-funded health insurance programs.

Medicare is specifically geared toward people 65 years and older or younger people receiving Social Security disability benefits. Medicaid is geared toward low income households.

Medicare is administered and funded federally, whereas Medicaid is funded federally but administered separately in each state.

While both programs allow qualification based on disability, there are some differences and overlaps to know about.

If you’re receiving Supplemental Security Disability Income (SSDI), you may be eligible for Medicaid, Medicare, or even both.

Medicare

Medicare is primarily intended for people 65 years and older. If you’re younger, you can qualify for Medicare if you have a disability and have been approved for Social Security Disability Insurance (SSDI).

In most cases, you’ll need to wait 24 months before your Medicare coverage begins, but there are two exceptions to the 2-year waiting period:

Medicaid

If you’re receiving SSDI, you might also be eligible for Medicaid, but the process for getting Medicaid depends on the specific rules in your state.

In some states, you may automatically qualify for Medicaid. In others, you’ll need to sign up yourself. There are also some states that don’t allow Medicaid eligibility based on disability. That said, rules may change yearly, so it’s a good idea to apply anyway.

Generally, each state sets its own income thresholds for Medicaid eligibility based on the federal poverty level.

There are also other ways you could qualify for Medicaid that can be connected to a disability, but unlike with Medicare, these are still related to your overall income. They are as follows:

  • Medically needy: Under this option, if you have a disability but earn more than the income threshold, you can qualify if your income exceeds the approved limit because of your medical expenses.
  • Special income level: If you or a loved one is living in a healthcare institution due to a medical condition, age, or disability, your state may provide Medicaid coverage if your earnings exceed the coverage threshold. This may also apply to people who receive home and community-based services instead of residing in a healthcare institution.
  • Working people with disabilities: States must cover certain people with disabilities whose income might otherwise make them ineligible. Additionally, some states may let other working individuals with disabilities purchase Medicaid coverage.

Whether Medicaid or Medicare is better for you if you have a disability depends on your situation, income, and the rules of Medicaid in your state.

Generally, Original Medicare (parts A and B) must offer certain medical benefits nationwide. In contrast, Medicaid coverage can vary from state to state.

That said, Medicaid in your state might provide coverage for some services that Medicare doesn’t or only partially covers, such as:

  • nursing home care
  • personal care
  • transportation to medical appointments
  • home- and community-based services
  • dental, vision, and hearing services

But another factor to consider is the difference in cost. Medicare generally costs more than Medicaid.

In 2025, after meeting a $257 deductible, Medicare Part B covers 80% of the cost of your medical care. For Part A, most people don’t pay a premium. You do need to meet a $1,676 deductible, after which Medicare only pays for full hospitalization for the first 60 days.

There are also additional costs if you enroll in Medicare Advantage (Part C) instead of Original Medicare (parts A and B) and if you enroll in Part D, which covers prescription drugs.

On the other hand, Medicaid caps your premiums, copayments, and coinsurance at 5% of your household income. If you earn below 150% of the federal poverty level, you won’t pay any premiums, and your copayments will be minimal. In addition, some medical services like emergency care, family planning, and preventive care for children can be free.

You may be able to be insured by both programs. You can fully qualify for both programs based on their eligibility criteria for people with disabilities. Alternatively, you may qualify partially through the Qualified Disabled Working Individual (QDWI) program.

If you fully qualify for both programs, Medicare will be the primary payer, and Medicaid will cover the costs of medical care that Medicare doesn’t cover.

On the other hand, with a Medicare savings program like QDWI, you don’t get benefits from Medicaid. Your benefits only come from Medicare, but Medicaid can help cover the cost of your Medicare Part A premium.

Medicare and Medicaid are two health insurance programs funded by the U.S. government. Medicare is designed for people 65 years and older or for younger individuals receiving Social Security disability benefits. Medicaid is geared toward low income households.

While Medicare is managed at the federal level, each state takes care of Medicaid separately. The eligibility criteria for disabilities differ for each program, and your coverage and costs will depend on which program you qualify for.

However, depending on your situation, you may qualify for both programs, which can add additional benefits, save money, or both.