Learn about Medicare, Medicaid and long-term care

Medicare and Medicaid are different government programs that help older adults cover health care costs.

In general, Medicare pays for short-term and preventative care, such as doctor's visits, screenings and hospital stays. Medicaid covers the cost of long-term care, such as a long-term nursing home stay, for eligible older adults.

Medicare is a federal health insurance program for people aged 65 or older. It has 4 parts:

  • Part A covers hospital stays, short-term nursing home care, hospice care and short-term home health care. People don't usually pay a premium for Part A if they or their spouse paid Medicare taxes while working. Most older adults are automatically enrolled in Part A.

  • Part B helps cover appointments with health professionals, durable medical equipment like walkers and wheelchairs, and preventative screenings. If they choose to have Part B, most people pay a standard monthly premium.

  • Part C, or Medicare Advantage Plans, are offered by private insurance companies and paid for out-of-pocket. They include all the benefits of Parts A and B, and may also cover prescription drugs or routine vision or dental care.

  • Part D is optional insurance offered by Medicare-approved private companies that helps pay for prescription drugs.

Medicare subsidies help some people cover Part B premiums or Part D premiums or co-pays.

Medicare supplements or Medigap plans are optional insurance policies that provide additional coverage around Parts A and B.

Medicaid is a joint federal and state program that helps low-income individuals and families pay for health care, regardless of age. Each state has different rules about eligibility and applying.

Older adults who qualify for Medicaid can get help paying for health care that's not routinely covered by Medicare, including:

  • Prescription drugs

  • Personal care, such as paid help with bathing, eating and dressing

  • Long-term stays in a nursing home

  • Long-term care at home, including visiting doctors and nurses, and personal care

Most older Americans will use some type of long-term care. However, older adults who need these services and don't qualify for Medicaid usually need to pay for them out of pocket.

Long-term care insurance can help cover the costs of long-term services and supports, including nursing and personal care in the home, in assisted living or nursing home residences.

People can choose between different long-term care insurance policies and pay regular premiums, as they do for other types of insurance. Older adults who are in poor health or already receiving long-term care services might not be able to purchase long-term care insurance, or might have fewer choices or higher rates.