Medicare and Medicaid sound almost identical, but they are two completely different programs. Medicare is federal health insurance based on age or disability. Medicaid is a state-run assistance program based on income and assets. Many Texas families mix them up, and that confusion can lead to missed benefits.
Key Takeaways
- Medicare is federal health insurance for people 65 and older (or younger people with certain disabilities). It is not based on income.
- Medicaid is a joint federal-state program for people with limited income and assets. In Texas, it is run by the Health and Human Services Commission (HHSC).
- You can have both. About 1.3 million Texans are "dual eligible," meaning they qualify for Medicare and Medicaid at the same time.
- If you have Medicare but struggle with premiums and copays, Texas Medicaid may cover those costs through Medicare Savings Programs.
Medicare at a Glance
Medicare is a federal program. It does not matter how much money you make. If you are 65 or older and a U.S. citizen or permanent resident, you are eligible. People under 65 with certain disabilities, ESRD, or ALS also qualify.
Medicare covers hospital stays (Part A), doctor visits and outpatient care (Part B at $185/month in 2026), and prescription drugs (Part D through private plans). Most people pay no premium for Part A.
The big gap: Medicare does not cover long-term custodial care, like daily help with bathing, dressing, and eating. That gap is one of the biggest reasons families turn to Medicaid.
Medicaid at a Glance
Medicaid is a joint federal and state program. In Texas, it is managed by HHSC. For seniors 65+, you must have limited income and assets. The income cap is $2,982 per month and the countable asset limit is $2,000 for a single person. Your primary home, one vehicle, and personal belongings are generally exempt.
Medicaid covers everything Medicare covers, plus long-term care (in a nursing home or at home through STAR+PLUS), dental, vision, hearing, personal care assistance, and transportation to medical appointments. For families caring for an aging parent, that long-term care coverage is often the most important benefit.
Side-by-Side Comparison
| Medicare | Medicaid (Texas) | |
|---|---|---|
| Run by | Federal government (CMS) | Texas HHSC (with federal funding) |
| Based on | Age or disability | Income and assets |
| Income test | No | Yes |
| Asset test | No | Yes ($2,000 for single person) |
| Covers long-term care | No (only short-term skilled nursing) | Yes |
| Monthly premium | Part B: $185/mo (2026) | Usually $0 for eligible seniors |
| Where to apply | ssa.gov | YourTexasBenefits.com or call 2-1-1 |
Can You Have Both?
Yes. If you qualify for both, you are considered "dual eligible," and it is one of the best positions to be in. Medicaid pays your Medicare premiums, covers your copays and deductibles, and adds benefits like long-term care, dental, vision, and hearing. Your out-of-pocket costs drop to nearly zero.
Even if you do not qualify for full Medicaid, Texas offers Medicare Savings Programs (MSPs) that help pay Medicare costs. QMB covers premiums, deductibles, and copays. SLMB and QI cover the Part B premium. These programs have higher income limits than full Medicaid, so you may qualify even if you were told you "make too much."
Not sure which programs your parent qualifies for? Start with our full guides:
Need help figuring out what your family qualifies for? Chat with Brevy. It is free and takes just a few minutes.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.