Yes, you can have both Medicaid and Medicare
You can hold both Medicaid and Medicare at the same time. In fact, millions of seniors do. When you have both programs, Medicare is your primary insurance — it pays first for covered services — and Medicaid pays some of what Medicare does not cover, like copayments, coinsurance, and deductibles. Medicaid can also cover services Medicare does not, such as long-term care in a nursing home or assisted living.
People with both programs are sometimes called "dual may be able to access" or "dually may be able to access." You do not need to choose between them. Having both can lower your out-of-pocket costs significantly, especially if your income and savings are limited.
Key Takeaways
- You can have Medicare and Medicaid at the same time; Medicare pays first, and Medicaid covers some costs Medicare does not.
- Medicaid covers services Medicare does not, including most nursing home care, assisted living, and personal care information at home.
- Each state sets its own Medicaid income and asset limits, so whether you may have access to depends on where you live.
- You must meet your state's Medicaid rules for income and assets even if you already have Medicare.
- Contact your state Medicaid office or a local Area Agency on Aging to find out whether you meet your state's Medicaid limits.
How having both programs works
When you have both Medicare and Medicaid, the two programs coordinate. Medicare covers hospital stays, doctor visits, and some skilled nursing care. Medicaid then covers the portions Medicare leaves you responsible for — your copayments, coinsurance, and deductibles. This coordination means you pay less out of pocket for services both programs cover.
Medicaid also fills gaps in Medicare coverage. Medicare does not cover long-term custodial care in a nursing home, but Medicaid does if you meet your state's rules. Medicare does not cover personal care information at home (help with bathing, dressing, or toileting), but Medicaid may. Medicaid can also cover dental care, vision care, and hearing aids in some states — services Medicare does not cover at all.
You keep your Medicare card and your Medicaid card. When you see a doctor or go to a hospital, you show both. The provider bills Medicare first, then sends the remaining balance to Medicaid.
Income and asset limits vary by state
Medicaid is a joint federal and state program, which means each state sets its own rules for who qualifies. Your state has limits on how much monthly income you can have and how many assets (savings, property, investments) you can own and still be Medicaid-may be able to access. These limits change from year to year and differ from state to state.
Some states use the federal poverty level as their income limit. Others set the limit higher. A few states have different rules depending on whether you are explore as a single person or a married couple. Your home and one vehicle are usually not counted as assets, but savings accounts, stocks, and rental property are.
Because limits vary so widely, you may may have access to in one state but not another. The only way to know whether you meet your state's rules is to contact your state Medicaid office directly or ask a local Area Agency on Aging to help you understand the limits.
How to learn about you may have access to for Medicaid
Start by contacting your state Medicaid office. You can find the phone number on your state's health department website or by calling 211 (a free helpline that connects you to local resources). Have your recent pay stubs, bank statements, and a list of your assets ready when you call.
An Area Agency on Aging in your county can also help. These agencies specialize in programs for older adults and can walk you through the income and asset rules for your state. They can tell you whether you likely may have access to before you contact Medicaid directly. Many also offer free help filling out Medicaid paperwork.
If you are already receiving Medicare, you do not need to do anything special to keep it while you pursue Medicaid. The two programs operate independently, so getting Medicaid does not affect your Medicare enrollment.
What Medicaid covers that Medicare does not
The most significant difference is long-term care. If you need to live in a nursing home for an extended period, Medicare covers only the first 100 days under very specific conditions (after a hospital stay of at least three days). Medicaid covers the rest, for as long as you need it, if you meet your state's rules. This is often the reason people with Medicare pursue Medicaid — to protect themselves against the cost of nursing home care.
Medicaid also covers personal care services at home in most states. This includes help with activities of daily living: bathing, dressing, toileting, eating, and moving around. Medicare does not cover this type of care unless it is part of skilled nursing care ordered by a doctor.
Depending on your state, Medicaid may also cover dental care, vision care, hearing aids, and transportation to medical appointments. Some states cover prescription drugs more generously than Medicare does. Check with your state Medicaid office about what is covered in your state.
Medicaid planning and protecting your assets
If you are concerned about spending down your savings to meet Medicaid's asset limits, you may want to speak with an elder law attorney. These lawyers specialize in Medicaid planning and can explain legal strategies for protecting assets while still meeting your state's rules. Some strategies involve transferring assets to family members or setting up trusts, but the rules are strict and vary by state.
Be cautious about moving money around on your own. Medicaid has a "look-back period" — usually five years — during which it examines your financial transfers. If you give away assets or transfer them to family members during this period, Medicaid may penalize you by delaying your coverage. An elder law attorney can help you understand what is and is not allowed in your state.
Some people also explore Medicaid-compliant annuities or other financial products designed to help you spend down assets in a way that does not trigger penalties. Again, these strategies are state-specific and require professional guidance.
What to ask your doctor and state Medicaid office
Ask your doctor: "Are there services I need that Medicare does not cover?" This helps you understand whether Medicaid would fill important gaps for you. Your doctor may also be able to refer you to a social worker or case manager who can help you understand your options.
Ask your state Medicaid office: "What is the current income limit for a single person (or married couple) in my state?" and "What assets do not count toward the limit?" Also ask whether your state has a program specifically for people who are already on Medicare — some states have streamlined Medicaid programs for dual-may be able to access seniors.
Ask an Area Agency on Aging: "Can you help me understand whether I likely meet my state's Medicaid rules?" and "Do you offer help filling out Medicaid paperwork?" These agencies often know about local programs and resources you might not find on your own.
When to seek help from a professional
Contact an elder law attorney if you have significant assets and are worried about protecting them while becoming Medicaid-may be able to access. These consultations are not free, but the cost may be worth it if you have substantial savings or property.
Reach out to your local Area Agency on Aging if you are unsure whether you may have access to or if the Medicaid process process feels overwhelming. Many offer free help and can answer questions about your state's specific rules.
If you are already on Medicaid and your income or assets change, report the change to your state Medicaid office. Failing to report changes can result in loss of coverage or having to repay benefits.
Frequently Asked Questions
Do I have to choose between Medicaid and Medicare?
No. You can have both at the same time. Medicare is your primary insurance, and Medicaid helps cover costs Medicare does not. You do not need to give up one to have the other.
Will getting Medicaid affect my Medicare benefits?
No. Medicare and Medicaid are separate programs. Getting Medicaid does not change your Medicare coverage, your premiums, or your benefits. The two programs straightforward work together to cover your costs.
What if my income is too high for Medicaid in my state?
Some states have special Medicaid programs for people with higher incomes who have high medical expenses. These programs allow you to "spend down" your income on medical costs and then become Medicaid-may be able to access. Ask your state Medicaid office whether your state has a spend-down program.
Can I keep my assets if I have Medicaid?
Your home and one vehicle are usually not counted. You can also keep a small amount of cash (the limit varies by state, typically between $2,000 and $3,000 for a single person). Beyond that, assets count toward Medicaid's limit. An elder law attorney can explain strategies specific to your state.
How long does it take to get Medicaid if I already have Medicare?
Processing time varies by state, typically between two weeks and two months. Contact your state Medicaid office to ask about current wait times. Some states process applications faster if you are already on Medicare.