Updated August 2025
If you’re not sure what the difference is between Medicare and Medicaid, you’re in good company. Many people mix them up. These two programs were both created in 1965 to help Americans pay for health care, but they work in different ways.
Our Executive Director at Bridges® by EPOCH at Norwalk has seen many residents come to their community who don’t understand how either of these systems works or how they apply to them in particular. And that’s okay, they say. Part of our job is to help make it all easier to understand.
“While it’s good to know the basics about these two programs, especially if you’re eligible for the benefits, there’s no reason you should have to become an expert,” they say. “With the ever-changing rules, regulations, requirements, and everything else, researching them would be your full-time job. We do our best to help our residents understand the benefits they qualify for, how they can use them to assist with covering health care costs and any changes that may affect them personally.”
Medicare – National Health Insurance
Medicare is a health insurance program run by the federal government. Most people become eligible at age 65, as long as they or their spouse have worked and paid taxes for at least ten years. Some people younger than 65 also qualify if they have certain disabilities or medical conditions, such as kidney failure requiring dialysis or ALS.
Part A – Hospital Insurance
Part A helps pay for hospital stays, short-term care in a nursing facility after a hospital stay, hospice care, and some home health care. Most people do not pay a monthly premium for Part A, but there is a deductible of $1676 each time you start a hospital stay, and coinsurance costs can apply if you stay longer than certain limits.
Part B – Medical Insurance
Part B covers visits to the doctor, outpatient care, tests, medical equipment like walkers or wheelchairs, and preventive services such as annual check-ups. In 2025, the monthly premium for Part B is $185, with a yearly deductible of $257. People with higher incomes—above $160,000 for a single person or $212,000 for a married couple—will pay more.
Part C – Medicare Advantage
Medicare Advantage is an alternative way to get your Medicare coverage. These plans are offered by private insurance companies approved by Medicare. They must cover everything that Parts A and B cover, and most also include prescription drug coverage. Many Advantage plans add extra benefits like dental, vision, or hearing care. You still pay your Part B premium, and sometimes an extra premium for the plan itself. It’s important to know that you cannot have Medicare Advantage and a Medigap supplement policy at the same time.
Part D – Prescription Drugs
Part D helps pay for prescription medicines. The cost varies depending on the plan you choose and your income. In 2025, the national base premium used to calculate penalties for late enrollment is $36.78 per month.
Medicaid – Health Coverage for People with Limited Income
Medicaid is a health care program for people with limited income and resources. It is run by both the federal and state governments, so the rules and benefits can change depending on where you live.
In Connecticut, Medicaid for seniors who need long-term care is called HUSKY C. To qualify, an individual usually must have no more than $1600 in countable assets, though certain property, like your home, may not count toward that limit. Income limits depend on the specific program you apply for.
Medicaid covers many of the same services as Medicare, such as doctor visits, hospital care, lab work, and x-rays. It also often covers prescription drugs, dental care, and vision care. One of the biggest differences is that Medicaid will pay for long-term care, such as a stay in a nursing home, for people who meet the requirements. Medicare, on the other hand, generally only covers short-term rehabilitation after a hospital stay and does not cover custodial long-term care.
What This Means for Dementia Care
For individuals living with Alzheimer’s disease or other forms of dementia, understanding the limits of Medicare and Medicaid is especially important.
Medicare will help cover medical needs related to dementia, such as doctor visits, hospital stays, and certain home health services, but it does not pay for long-term custodial care in a memory care community or nursing home.
Families often turn to Medicaid when a loved one needs ongoing daily assistance with personal care, since Medicaid can cover the cost of long-term residential care for those who meet income and asset limits. Planning ahead is key, as qualifying for Medicaid often requires spending down assets and navigating state-specific rules, which can take time.
Dual Eligibility – Having Both Medicare and Medicaid
Some people qualify for both Medicare and Medicaid at the same time. This is called being “dual eligible.” In these cases, Medicare pays for covered medical services first, and Medicaid helps cover costs that Medicare does not pay for, such as premiums, deductibles, and co-pays, as well as additional services.
“Medicaid and Medicare can be confusing to navigate, which is why we at Bridges® by EPOCH at Norwalk stay up-to-date on policy changes and regulations in order to best help our residents and families,” says our ED. “Our goal is to help you and your loved ones manage the dementia journey with the highest quality of life possible. During this time, you shouldn’t have to be worrying and wondering what’s covered and what’s not with your insurances. We are happy to help at any time, whether you’re a member of our community or not. We are here to provide support, advice and assistance however it’s needed.”
For more information about the basics of Medicare and Medicaid, or to learn more about our memory care assisted living community, please contact us today.
Compassionate Care for All Stages of Memory Loss
Bridges® by EPOCH at Norwalk provides assisted living memory care that is comfortable, positive, safe and engaging. Exclusively dedicated to caring for those with Alzheimer’s disease and other forms of dementia or memory impairment, we’ve created a wellness-focused lifestyle that promotes dignity and individual preferences. Our memory care professionals receive specialized and ongoing training designed to help residents maximize their independence in a secure, calm environment – making a truly positive impact on the lives of our residents each and every day.
Personalized Services
Bridges® by EPOCH at Norwalk’s services are designed to recognize and adapt to the unique challenges and individuality of each resident, while ensuring comfort and safety. We believe in a full-service approach to care and provide a high level of personalized attention for every stage of memory loss.
We know that navigating the details of Medicare and Medicaid is only one part of the caregiving journey. That’s why we offer caregiver support groups and educational sessions throughout the year. These events provide families with guidance, resources, and a community of others who understand the challenges of memory care. By sharing experiences and learning together, caregivers feel supported and empowered while planning for their loved one’s future.
Community Amenities
Within a beautiful residential design, Bridges® by EPOCH at Norwalk provides everything residents with Alzheimer’s disease and other dementias need to enjoy comfort, familiarity and security. Soft colors, directional cues, aromatherapy and interactive life stations create a peaceful and secure environment where residents feel at home.
Contact us today to learn more or to schedule a tour.