Medicare and Medicaid get confused constantly, partly because the names sound alike and partly because some people qualify for both at once. The cleanest way to tell them apart: Medicare is about age or disability, Medicaid is about income. * Medicare is a federal program, run the same way in every state, primarily covering people age 65 and older, along with certain younger people with qualifying disabilities. Eligibility isn't based on how much money you have — a retired teacher and a retired billionaire both qualify at 65 on the same terms. * Medicaid works completely differently. It's a joint federal and state program: Washington sets the basic framework and provides funding, but each state runs its own program, decides its own income cutoffs, and determines its own specific benefits within federal guidelines. That's why Medicaid eligibility and coverage can look meaningfully different depending on which state you live in, while Medicare looks the same everywhere. * Someone can qualify for both programs simultaneously — these are usually called "dual eligible" beneficiaries, typically people 65 or older with limited income and assets. In that situation, Medicaid often helps cover costs Medicare doesn't, like long-term nursing home care, which Medicare generally doesn't cover at all. * If you're not sure which program applies to your situation, the starting point is simple: check your age and disability status for Medicare, and check your household income against your state's specific Medicaid threshold for Medicaid — they're evaluated on entirely separate criteria.