Differences Between Medicare vs. Medicaid vs. Private Insurance

Difference between Medicare vs. Medicaid

It’s not uncommon to wonder what the difference is between Medicare and Medicaid. Medicare is a federal government-run program that provides health insurance to those who have a disability or are over 65 years old. There are no income requirements for Medicare.¹

On the other hand, Medicaid is a government and state-run program that helps provide insurance to those with low income.² The income requirements vary from state to state, so we recommend researching the state you live in and Medicaid guidelines.

In some cases, you may qualify for both Medicare and Medicaid. You are able to use both at the same time. When both Medicare and Medicaid work together, you’re more likely to receive better coverage and have fewer out-of-pocket costs.³

Difference between Medicare vs. private health insurance

Even if you qualify for Medicare, you may want to assess all your health insurance options. For example, if you are over 65 but haven’t retired, you may still get private insurance options from your employer. Your employer-provided plan may offer better coverage than Medicare.

If you aren’t getting insurance through your employer, you can still shop for private insurance through the insurance marketplace. When shopping for a plan, you’ll want to consider how much the monthly payments are (premiums), what out-of-pocket costs will look like after insurance is used, and what all is covered. Looking at each insurance plan carefully is helpful during this part of the process.⁴

When choosing between Medicare and a private health insurance plan, it depends on what your priorities are. You’ll want to compare the costs and benefits of the private insurance plans you are considering and Medicare. For your reference, Medicare monthly premiums can cost up to $170.⁵ On the other hand, the average cost of private health insurance for individuals is $456 per month.⁶

You’ll also want to consider the network of doctors you can choose from in a private health insurance plan vs. Medicare. With Medicare, you can go to any doctor who accepts the National program—and many doctors do.⁷ You may have more options within a private health insurance plan, but it depends on which one you are considering and how it functions. The specific coverage offered varies from plan to plan, so we recommend looking at each insurance option with a close eye.

Difference between Medicaid vs. private health insurance

Price is usually the main determinant when comparing Medicaid and private health insurance. Since Medicaid is offered to those with low income, the cost of private health insurance can sometimes be more expensive.

Medicaid exists to help provide insurance to those who cannot afford it, and it fulfills a necessary role in the healthcare system. In fact, around 70 million Americans used Medicaid coverage in 2020.⁸ On the other hand, you may receive better coverage options through a private health insurance company.⁹ Which insurance option you choose ultimately depends on the coverage and cost of the private health insurance plan you are considering.

Supplemental insurance to complement your primary plan

Now that you understand the difference between Medicare and Medicaid and your options regarding private health insurance, you may have a better idea of what your next steps look like. Regardless of your chosen plan, medical expenses may not be covered by insurance. Aflac Supplemental Insurance works with your existing plan to help offset those costs.

We provide supplemental cancer, hospital, critical illness, vision, accident, short-term disability, dental insurance, and pet. Chat with an agent to discover how our plans can easily fit your budget. Still not sure which of our supplemental plans can support you best?