You can have both Louisiana Medicaid and Medicare at the same time

When you turn 65 or become may be able to access for Medicare through disability or end-stage renal disease, you do not lose your Louisiana Medicaid. The two programs work together — Medicare becomes your primary insurance, and Medicaid fills in gaps like copayments, deductibles, and services Medicare does not cover. This combination is called dual coverage, and it is common in Louisiana.

The key is enrolling in Medicare on time and then notifying Louisiana Medicaid that you now have Medicare. If you miss Medicare's enrollment window, you may face a permanent penalty on your premiums. Louisiana Medicaid will not automatically know you have enrolled in Medicare, so you must report it yourself.

Key Takeaways

  • Enroll in Medicare Part A and Part B during your Initial Enrollment Period — the three months before, the month of, and three months after your 65th birthday — to avoid a lifetime premium penalty.
  • Report your Medicare enrollment to Louisiana Medicaid within 30 days by calling the Medicaid hotline at 1-888-342-6207 or submitting a change form online through the Louisiana Department of Children and Family Services portal.
  • Once you have both programs, Medicare pays first for covered services, and Louisiana Medicaid pays your Medicare copayments, coinsurance, and deductibles if you remain income-may be able to access.
  • If you are enrolled in a Louisiana Medicaid managed care plan, you may need to switch to a plan that coordinates with Medicare, or you may be automatically moved to a dual-may be able to access plan.

When to enroll in Medicare if you have Louisiana Medicaid

Your Initial Enrollment Period for Medicare runs for seven months: three months before your 65th birthday, the month you turn 65, and three months after. If you enroll during this window, your Medicare Part A and Part B coverage begins on the first day of your birth month (or the first day of the month you become may be able to access, if that is earlier).

If you miss this window, you can still enroll during the General Enrollment Period from January 1 to March 31 each year, but your coverage will not start until July 1 of that year. More importantly, you will owe a lifetime premium penalty — your Part B premium will be 10 percent higher for every 12-month period you were may be able to access but did not enroll. This penalty never goes away.

Having Louisiana Medicaid does not extend your enrollment window or waive the penalty, so treat your Initial Enrollment Period as firm. If you are unsure whether you are may be able to access for Medicare, call Social Security at 1-800-772-1213 to confirm your may be able to access date.

How to enroll in Medicare while on Louisiana Medicaid

You can enroll in Medicare through three routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Online enrollment is fastest — you can complete it in about 15 minutes if you have your Social Security number and birth certificate information ready.

When you enroll, you will choose whether to take Original Medicare (Part A and Part B) or to join a Medicare Advantage plan (Part C). If you are on Louisiana Medicaid, Original Medicare is usually the better choice because Medicaid can pay your copayments and deductibles more easily. Medicare Advantage plans have their own copayment structures, and Medicaid's role in covering those costs varies by plan and by state rules.

You do not need to enroll in Part D (prescription drug coverage) at the same time, but if you do not have creditable drug coverage through Medicaid, you should enroll in Part D during your Initial Enrollment Period to avoid a late-enrollment penalty on your premiums.

Reporting your Medicare enrollment to Louisiana Medicaid

After you enroll in Medicare, you must tell Louisiana Medicaid within 30 days. The fastest way is to call the Louisiana Medicaid hotline at 1-888-342-6207 (Monday through Friday, 7:30 a.m. to 5:00 p.m. Central Time). Have your Medicare card or your Social Security number ready. The representative will update your file so Medicaid knows you now have Medicare as your primary insurance.

You can also report the change online through the Louisiana Department of Children and Family Services portal at www.dcfs.la.gov. Log in to your account, go to "Manage Your Case," and select "Report a Change." Upload a photo of your Medicare card or provide your Medicare number. Processing usually takes 5 to 10 business days online.

If you are enrolled in a Louisiana Medicaid managed care plan (such as Healthy Louisiana or a regional plan), call your plan's member services line as well. Some plans need to know about your Medicare enrollment to coordinate benefits correctly, and some may move you to a different plan designed for people with dual coverage.

What happens to your Louisiana Medicaid after you enroll in Medicare

Your Louisiana Medicaid does not end when you enroll in Medicare. Instead, it becomes secondary coverage. Medicare pays first for any service it covers. Medicaid then pays your Medicare copayments, coinsurance, and deductibles — this is called cost-sharing — if you remain income-may be able to access for Medicaid.

Louisiana Medicaid income limits for people over 65 are higher than for working-age adults. As of 2024, the limit is roughly 100 percent of the federal poverty level, but this varies by household size and changes annually. If your income is above the limit, you will lose Medicaid even if you remain on Medicare. Call 1-888-342-6207 to confirm your current income limit.

Medicaid also covers some services Medicare does not, such as long-term care in a nursing home (if you meet medical and financial criteria) and personal care information at home. These benefits continue as long as you are Medicaid-may be able to access, even after you enroll in Medicare.

If you are in a Louisiana Medicaid managed care plan

Louisiana Medicaid offers coverage through managed care plans in most parishes. If you are enrolled in one of these plans when you turn 65 and enroll in Medicare, your plan status may change automatically or you may need to make a choice.

Some Louisiana managed care plans are dual-may be able to access plans — they are designed to serve people with both Medicare and Medicaid. If your current plan offers a dual-may be able to access version, you may be moved to it automatically. Other plans may disenroll you when you enroll in Medicare, and you will need to choose a new Medicaid plan or return to fee-for-service Medicaid (where you see any Medicaid provider without being locked into a plan).

Your plan will send you a notice if your enrollment is changing. Read it carefully and call your plan's member services line if you have questions. If you are disenrolled and do not choose a new plan within 30 days, Louisiana Medicaid will assign you to a plan or to fee-for-service coverage.

What to do if you missed your Medicare enrollment window

If you are already over 65 and did not enroll in Medicare during your Initial Enrollment Period, you can still enroll, but you will face a permanent premium penalty. The penalty applies to Part B (medical insurance) and Part D (drug coverage) if you enroll late in those parts.

You can enroll during the General Enrollment Period (January 1 to March 31) each year, with coverage starting July 1. If you have a may have access to life event — such as loss of other health coverage or a change in your Medicaid status — you may be able to enroll outside these windows. Call 1-800-MEDICARE to ask whether you may have access to for a Special Enrollment Period.

Having Louisiana Medicaid does not waive the penalty, but it does help cover the higher premiums you will owe. This is another reason to report your Medicare enrollment to Medicaid quickly — the sooner Medicaid knows about your Medicare premiums, the sooner it can help pay them.

Frequently Asked Questions

Do I have to choose between Louisiana Medicaid and Medicare?

No. You keep both. Medicare becomes your primary insurance at 65 or when you may have access to through disability, and Louisiana Medicaid continues as secondary coverage. Medicaid will pay your Medicare copayments and deductibles as long as you remain income-may be able to access for Medicaid.

What if I am on Louisiana Medicaid and turn 65 but do not want Medicare?

You can decline Medicare, but this is rarely a good idea. Medicare Part A (hospital insurance) is free if you or your spouse paid Medicare taxes for at least 10 years. Part B (medical insurance) has a monthly premium, but Medicaid can pay it for you. Declining Medicare means you lose access to Medicare-covered services and may face a penalty if you enroll later.

Will Louisiana Medicaid pay my Medicare Part B premium?

Yes, if you remain income-may be able to access for Medicaid. Medicaid will pay your Part B premium, your Part A premium (if you have one), and your cost-sharing (copayments, coinsurance, and deductibles). This is one of the biggest advantages of having dual coverage.

What if my Louisiana Medicaid is denied after I enroll in Medicare?

If your income exceeds the Medicaid limit or you are found ineligible for another reason, you will lose Medicaid but keep Medicare. You can request a hearing to appeal the denial. Call 1-888-342-6207 to ask how to file an appeal, or visit the Louisiana Department of Children and Family Services website for the appeals process.

Do I need to enroll in a Medicare Advantage plan or can I stay with Original Medicare?

You can choose either. Original Medicare (Part A and Part B) works better with Louisiana Medicaid because Medicaid can pay your copayments and deductibles more straightforwardly. Medicare Advantage plans have different cost structures, and Medicaid's role in paying those costs is more complex. If you are on Medicaid, Original Medicare is usually the simpler choice.