The difference is in who pays and how you got coverage

Medicare is federal health insurance you earn by paying into Social Security while working — you become covered at 65 or earlier if you have a disability or end-stage renal disease. Medicaid is state-run insurance for people with low income, regardless of age or work history. The simplest way to know which one you have: Medicare comes from your work record; Medicaid comes from your income and household size.

If you are unsure, your insurance card will say "Medicare" or "Medicaid" at the top. If you have both, the card will show both names. You can also call the number on your card, or contact your state Medicaid office or Medicare directly at 1-800-MEDICARE.

Key Takeaways

  • Your insurance card displays the program name at the top — Medicare or Medicaid — so checking your card is the fastest way to know.
  • Medicare is based on your work history and age; Medicaid is based on your income and household size.
  • You can have both programs at the same time, which is called "dual coverage."
  • Calling the number on your card or contacting your state Medicaid office will confirm your coverage type within minutes.

How to check your insurance card

Look at the top of your card. If it says "Medicare," you have federal insurance tied to your work record. If it says "Medicaid," you have state insurance based on income. The card will also show your member ID number and the phone number to call with questions.

If you cannot find your card, you can request a replacement by calling the number listed above, or by logging into your online account if you have one set up. Most people can get a replacement card mailed within 7 to 10 business days.

What to do if you have both Medicare and Medicaid

Some people may have access to for both programs — usually older adults or people with disabilities who have low income. This is called dual coverage. When you have both, Medicare is your primary insurance and pays first; Medicaid pays second and covers costs Medicare does not.

If you have dual coverage, you will have two separate cards. Medicare will be your main card, and Medicaid will be your secondary card. You should bring both cards to every doctor visit and hospital stay. Tell the provider you have both so they bill correctly.

How to contact Medicare or Medicaid directly

Medicare: Call 1-800-MEDICARE (1-800-633-4227) Monday through Friday, 8 a.m. to 8 p.m. Eastern time. You can also visit Medicare.gov or create an account to check your coverage online.

Medicaid: Contact your state Medicaid office directly — the phone number and website vary by state. You can find your state office by visiting Medicaid.gov and selecting your state, or by calling 211 and asking for your local Medicaid office. Response times vary, but most offices can confirm your coverage status within one business day.

What information you will need to verify your coverage

When you call either program, have the following ready: your full name, date of birth, Social Security number, and current address. If you are calling about someone else's coverage (such as a family member), you may need to provide proof that you have permission to ask.

If you have recently moved, changed your name, or updated your income, tell the representative that when you call. These changes can affect which program covers you or whether you have both.

What happens if you are not sure you have active coverage

If you think you should have Medicare or Medicaid but cannot find a card or confirm coverage, call the program directly using the numbers above. They can tell you whether coverage is active, whether it lapsed, or whether you need to take a step to renew it.

If you had coverage in the past but it ended, the representative can explain why and what you need to do to get it back. Some programs have waiting periods; others will restart coverage immediately once you meet the requirements again.

Frequently Asked Questions

Can I have Medicare and Medicaid at the same time?

Yes. People who are 65 or older with low income, or people under 65 with disabilities and low income, often have both. Medicare is primary and pays first; Medicaid covers what Medicare does not. You will receive two separate cards.

What if my card says something other than Medicare or Medicaid?

You may have private insurance through an employer or the marketplace, or you may have a Medicare Advantage plan (which is Medicare but run by a private company). The card will still show the program name. Call the number on the card to confirm what type of coverage you have.

How do I know if my Medicaid coverage is still active?

Call your state Medicaid office or visit your state's Medicaid website and log into your account. They can tell you the end date of your current coverage. Medicaid coverage can end if your income increases, your household size changes, or you reach the age limit in your state.

What if I lost my Medicare or Medicaid card?

Call the program using the number above and request a replacement. Medicare usually mails a new card within 7 to 10 business days. Medicaid timelines vary by state, but most send replacements within 2 to 3 weeks. You can use your member ID number from your old card or account while you wait.

Do I need to do anything to keep my coverage active?

Medicare coverage is automatic once you turn 65 and does not require renewal. Medicaid requires annual renewal in most states — you will receive a notice in the mail with instructions. If you do not renew by the deadline, your coverage will end.