Medicare and Medicaid are both federal programs but very different. Medicaid is for low-income, financially needy people and is administered by each state in different ways. Medicare is not based on your need level. It’s an entitlement program that you are owed because you or your spouse paid into to the program through employment or self-employment taxes throughout your working years. You can qualify for both Medicaid and Medicare programs at the same time but they have different requirements.