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When choosing a health insurance plan, you should consider all your options. You’ll want to check if you qualify for government-run programs like Medicare and Medicaid based on age, income, and disability status. Even if you qualify for one of these programs, you could still choose a private insurance plan from the insurance marketplace.
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It’s important to note that Aflac does not offer primary health insurance. However, we offer supplemental insurance plans that can work alongside your existing plan to help cover gaps in coverage, whether you have Medicare, Medicaid, or a private plan.
We have a variety of plans that can help cover unexpected or out-of-pocket expenses. For example, our hospital insurance helps pay for the costs associated with hospital expenses. In contrast, our critical illness insurance helps cover whatever you need after a covered life-changing illness.
Read on to learn how Medicare and Medicaid work and what they cover, the differences between them, and how these plans compare to private health insurance.
It’s not uncommon to wonder what the difference is between Medicare and Medicaid. Medicare is a federal government-run program that provides health insurance to those who have a disability or are 65+. There are no income requirements for Medicare.1
On the other hand, Medicaid is a federal and state-run program that helps provide insurance to those with low income.1 The income requirements can vary from state to state, so we recommend researching the Medicaid guidelines in the state you live in.
In some cases, you may qualify for both Medicare and Medicaid. You are able to use both at the same time.2 Typically, when both Medicare and Medicaid work together, you’re more likely to receive better coverage and have fewer out-of-pocket costs.
Don’t wait until it’s too late. Help cover yourself and your family with coverage from Aflac.
Get StartedHere are some key differences between Medicare, Medicaid, and private health insurance plans:
Even if you qualify for Medicare, you may want to assess all your health insurance options. For example, if you are over 65 but haven’t retired, you may still get private insurance options from your employer. Your employer-provided plan may offer better coverage than Medicare.
If you aren’t getting insurance through your employer, you can still shop for private insurance through the insurance marketplace. When shopping for a plan, you’ll want to consider how much the monthly premiums are, what your out-of-pocket costs will look like after insurance is used, and what all is covered. Looking at each insurance plan carefully is helpful during this part of the process.
When choosing between Medicare and a private health insurance plan, it depends on what your priorities are. You’ll want to compare the costs and benefits of the private insurance plans you are considering and Medicare. For your reference, Medicare monthly premiums can cost up to $175.3 On the other hand, the average cost of private health insurance for individuals is $477 per month.3
You’ll also want to consider the network of doctors you can choose from in a private health insurance plan vs. Medicare. With Medicare, you can go to any doctor who accepts the National program—and many doctors do.3 You may have more options within a private health insurance plan, but it depends on which one you are considering and how it functions. The specific coverage offered varies from plan to plan, so we recommend looking at each insurance option with a close eye.
Price is usually the main determinant when comparing Medicaid and private health insurance. Since Medicaid is offered to those with low income, the cost of private health insurance can sometimes be more expensive.
Medicaid exists to help provide insurance to those who cannot afford it, and it fulfills a necessary role in the healthcare system. In fact, around 72 million Americans are enrolled in Medicaid coverage.4 On the other hand, you may receive better coverage options through a private health insurance company. Which insurance option you choose ultimately depends on the coverage and cost of the private health insurance plan you are considering.
Medicare and Medicaid are both types of health insurance that can offer great coverage and help lower your out-of-pocket costs. Now that you understand the differences between Medicare and Medicaid and your options regarding private health insurance, you may have a better idea of what your next steps look like. Regardless of your chosen plan, some medical expenses may not be covered by insurance. Aflac supplemental insurance can work with your existing plan to help cover those costs.
We provide supplemental cancer, hospital, critical illness, vision, accident, short-term disability, and dental insurance. Chat with an agent to discover how our insurance plans can easily fit your budget.
Get Started
Looking to buy affordable health insurance? Learn what your options are and how to get the right affordable health insurance plan for you.
Supplemental insurance plans often come with affordable premiums. Learn about how much supplemental health insurance costs and get a quote.
Looking to buy affordable health insurance? Learn what your options are and how to get the right affordable health insurance plan for you.
Supplemental insurance plans often come with affordable premiums. Learn about how much supplemental health insurance costs and get a quote.
1 Medicare Interactive - Differences between Medicare and Medicaid. Updated March 28, 2025. Accessed June 2, 2025. https://www.medicareinteractive.org/get-answers/medicare-basics/medicare-coverage-overview/differences-between-medicare-and-medicaid.
2 National Council on Aging, Inc. - What Does it Mean to Be Dual-Eligible for Medicare and Medicaid? Updated June 28, 2024. Accessed June 2, 2025. https://www.ncoa.org/article/what-does-it-mean-to-be-dual-eligible-for-medicare-and-medicaid/.
3 EHealth - How Much Does Individual Health Insurance Cost. Updated October 16, 2024. Accessed June 2, 2025. https://www.ehealthinsurance.com/resources/individual-and-family/how-much-does-individual-health-insurance-cost.
4 PBS - 1 in 5 Americans are on Medicaid. Some enrollees have no idea. Updated April 13, 2025. Accessed June 2, 2025. https://www.pbs.org/newshour/health/1-in-5-americans-are-on-medicaid-some-enrollees-have-no-idea.
Content within this article is provided for general informational purposes and is not provided as tax, legal, health, or financial advice for any person or for any specific situation. Employers, employees, and other individuals should contact their own advisers about their situations. For complete details, including availability and costs of Aflac insurance, please contact your local Aflac agent.
Aflac Coverage:
Accident, A36000 series: In Idaho, Policies A36100ID–A36400ID, & A363OFID. In Virginia, Policies A36100VA – A36400VA, & A363OFVA. A37000 series: In Delaware, Policy A371AA & A371BA. In Oklahoma, Policy A37000OK. In Virginia, Policies A371AAVA & A371BAVA. A38000 series: In Delaware Policies A38100DE – A38300DE, In Oklahoma A38100OK – A38300OK.
Cancer/Specified-Disease, B70000 series: In Delaware, Policies B70100DE, B70200DE & B70300DE. In Idaho, Policies B70100ID, B70200ID, B70300ID, B7010EPID, B7020EPID. In Oklahoma, Policies B70100OK, B70200OK, B70300OK, B7010EPOK, B7020EPOK. 75000 series: In Virginia, policies A75100VA–A75300VA. Cancer insurance is also known as specified disease insurance in some states.
Critical Illness/Specified Health Event, A74000 series: In Delaware, Policies A74100DE, A74200DE, A74300DE. In Idaho, Policies A74100ID, A74200ID, A74300ID. In Oklahoma, Policies A74100OK, A74200OK, A74300OK. In Virginia, Policies A74100VA, A74200VA, A74300VA. A73000 series: In Delaware, Policies A73100DE & A7310HDE. In Idaho, Policies A73100ID & A7310HID. In Oklahoma, Policies A73100OK & A7310HOK. In Virginia, Policy A73100VA & A7310HVA. B71000 series: In Delaware, Policies B71100, B71200, B7130H & B7140H. In Oklahoma, Policies B71100OK & B7110HOK.
Dental, A82000 series: In Delaware, Policies A82100R–A82400R. In Idaho, Policies A82100RID–A82400RID. In Oklahoma, Policies A82100ROK–A82400ROK. In Virginia, Policies A82100RVA–A82400RVA.
Hospital, B40000 series: In Delaware, Policies B40100DE & B4010HDE. In Idaho, Policies B40100ID & B4010HID. In Oklahoma, Policies B40100OK & B4010HOK. In Pennsylvania, Policies B40100PA & B4010HPA. In Virginia, Policies B40100VA & B4010HVA.
Short-Term Disability, A57600 series: In Delaware, Policies A57600DE & A57600LB. In Idaho, Policy A57600IDR. In Oklahoma, Policies A57600OK & A57600LBOK. In Virginia, Policies A57600VA & A57600LBVA.
Vision, VSN series: In Delaware, Policy VSN100. In Idaho, Policy VSN100ID. In Oklahoma, Policy VSN100OKR. In Virginia, Policy VSN100VA.
Aflac coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, Aflac coverage is underwritten by American Family Life Assurance Company of New York.
Tier One Coverage:
Accident, T37000 series: In Delaware, Policy T37000. In Idaho, Policies T37100ID, T37200ID, & T37300ID. In Oklahoma, Policy T37000OK. In Virginia, Policies T37100VA, T37200VA, T37300VA, T37400VA & T37600VA.
Cancer/Specified Disease plans, T70000 series: In Delaware, Policy T70000. In Idaho, Policy T70000ID. In Oklahoma T70000OK, In Virginia, policies T70000VA & T70000GVA.
Critical Illness, T71000 series: In Delaware, Policy T71000. In Oklahoma, Policy T71000OK. In Virginia, Policy T71100VA.
Dental, Vision and Hearing: In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. Not available NY or VA. Dental claims are administered by SKYGEN USA, LLC. Vision claims are administered by EyeMed Vision Care, LLC. Hearing claims are administered by Nations Hearing. NOTICE: The coverage offered is not a qualified health plan (QHP) under the Patient Protection and Affordable Care Act (ACA) and is not required to satisfy essential health benefits mandates of the ACA. The coverage provides limited benefits.
Tier One coverage is underwritten by Tier One Insurance Company. Tier One Insurance Company is part of the Aflac family of insurers. In California, Tier One Insurance Company does business as Tier One Life Insurance Company (NAIC 92908).
Coverage may not be available in all states, including but not limited to DE, ID, NJ, NM, NY, VA or VT. Benefits/premium rates may vary based on state and plan levels. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policy and rider forms for benefit details, definitions, limitations, and exclusions.
Aflac WWHQ | Tier One Insurance Company | 1932 Wynnton Road | Columbus, GA 31999
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