Medicare vs. Michigan Medicaid: The Difference

Medicare and Medicaid both provide health coverage, but they serve very different populations and operate under distinct rules, particularly in Michigan.

Medicare: Federal Health Insurance for Age or Disability

Medicare is a federal program managed by the Centers for Medicare & Medicaid Services (CMS) https://www.medicare.gov .

It’s primarily for:

• People 65 and older, regardless of income

• People under 65 with certain disabilities (after 24 monthly payments on SSDI)

• People with End-Stage Renal Disease (ESRD) or ALS

  
  

Coverage structure:

• Part A: Hospital insurance (inpatient care, skilled nursing, hospice)

• Part B: Medical insurance (doctor visits, outpatient care, preventive services)

• Part D: Prescription drug coverage

• Part C (Medicare Advantage): Private plans combining A, B, and often D

  
  

Funding: Payroll taxes and premiums.

Administration: Entirely federal:  benefits are the same in every state.

Michigan Medicaid: State-Federal Partnership for Low-Income Residents

Michigan Medicaid is a joint federal-state program that provides free or low-cost coverage for people with limited income and assets.

It covers:

• Children, pregnant women, and parents

• Adults under 65 with low income (Healthy Michigan Plan)

• People with disabilities or seniors with low income (including those on SSDI before Medicare eligibility)

  
  

Key Michigan programs:

• Healthy Michigan Plan: For adults up to 138% of the federal poverty level

• MI Choice Waiver: Home and community-based services for seniors who’d otherwise need nursing home care

• Medicaid for the Aged, Blind, and Disabled: For those with limited income/assets who don’t qualify for the Healthy Michigan Plan

  
  

Funding: Shared by federal and state governments.  

ManleyReynolds, PLLC, offices have an on-site Medicare Advantage agent through ManleyReynolds Insurance Support, with a dedicated phone number of 248-780-8193.  She will be happy to assist with questions you may have about Medicare Advantage (Part C) programs.  

Our office does not handle any State benefits, including Medicaid, and will not be able to answer questions about the requirements or how to qualify for Medicaid.  We suggest you visit https://www.michigan.gov/mdhhs/assistance-programs/medicaid as a place to start finding answers to your questions.