What is Medicaid and how does it differ from Medicare?

Medicaid and Medicare are easily confused but serve different populations. Medicaid is a joint federal-state program (states administer with federal matching funds) providing health coverage to low-income individuals and families, based on income and family size. Eligibility rules and benefits vary by state, especially after the ACA gave states the option to expand Medicaid to all adults under 138% of federal poverty level. Medicare is a federal program for Americans 65+, certain disabled persons, ESRD patients, and ALS patients, based on age or disability rather than income. Some people qualify for both (dual-eligibles); Medicare is primary in that case. Medicaid covers nursing home care (after asset spend-down); Medicare provides only limited skilled nursing facility coverage.