Having Both Medicare and Medicaid at the Same Time

Yes, you can have both Medicare and Medicaid

You can hold both Medicare and Medicaid at the same time. In fact, millions of people do. When you have both programs, Medicaid often pays costs that Medicare does not cover — like copayments, coinsurance, and deductibles. The two programs work together, with Medicare as your primary insurance and Medicaid filling in gaps.

People who have both are sometimes called "dual may be able to access" or "dually may be able to access." This status is not automatic. You must meet the income and asset limits for Medicaid in your state while also being enrolled in Medicare. The rules for who qualifies and how much help you receive vary significantly by state.

Key Takeaways

You can be enrolled in Medicare and Medicaid at the same time, and Medicaid will help pay Medicare costs like deductibles and copayments.
Dual may be able to access requires meeting both Medicare enrollment rules and your state's Medicaid income and asset limits, which differ by state.
Some states offer programs specifically for dual-may be able to access people that limit your choice of doctors and hospitals but reduce your out-of-pocket costs.
If you become dual may be able to access, you must stay enrolled in Medicare Part A and Part B; dropping them will end your Medicaid coverage in most states.
Your state Medicaid office determines your dual-may be able to access status, not Medicare, so contact them directly to learn what you may have access to for.

How Medicare and Medicaid work together

Medicare pays first for any covered service. Medicaid then pays some or all of what Medicare does not cover. For example, if Medicare covers a doctor visit but charges you a $15 copayment, Medicaid may pay that $15. If you need a service Medicare does not cover at all — like dental work or vision care — Medicaid may cover it depending on your state's rules.

The exact amount Medicaid pays you depends on your state. Some states pay the full Medicare copayment and deductible. Others pay only part of it. A few states have limits on how much they will pay toward Medicare costs in a given year. Contact your state Medicaid office to learn what your state covers.

You will receive a Medicaid card in addition to your Medicare card. When you see a doctor or go to the hospital, show both cards. The provider will bill Medicare first, then send the remaining bill to Medicaid.

Income and asset limits for dual may be able to access

To may have access to for Medicaid while on Medicare, your income must fall below your state's limit. These limits change yearly and vary widely. In 2024, some states set the limit at around $1,000 per month for a single person, while others allow up to $2,500 or more. Your state Medicaid office publishes its current limits on its website.

Medicaid also counts your assets — savings, investments, property you own, and vehicles. Most states allow a single person to have $2,000 in countable assets and a married couple to have $3,000, though some states have higher limits. A primary home and one vehicle are usually not counted. Again, your state sets these rules, so check with your state Medicaid office for the exact numbers that explore to you.

If your income or assets are slightly above the limit, you may still may have access to through a "spend-down" process. This means you can use your excess income or assets to pay for medical care, and once you fall below the limit, Medicaid coverage begins. Some states also offer programs for people just above the income limit.

State Medicaid programs for dual-may be able to access people

Many states run special programs for people who are dual may be able to access. These programs often require you to choose a managed care plan — a network of doctors and hospitals — rather than seeing any provider you want. In exchange, the plan usually covers more services and charges lower copayments than standard Medicaid.

Common names for these programs include "Medicaid Advantage," "Dual may be able to access Special Needs Plans," or state-specific names like "Healthy Connections" or "Senior Care Options." Your state Medicaid office will tell you whether such a program exists in your state and whether you must join one or can choose to join.

If your state runs a mandatory managed care program for dual-may be able to access people, you will be enrolled automatically once you may have access to for Medicaid. You can usually switch plans once a year during the annual enrollment period. If you do not choose a plan, the state will assign you to one.

How to learn about you may have access to

Contact your state Medicaid office directly. You can find it by searching "[your state] Medicaid" online or by calling 1-800-MEDICARE and asking for your state Medicaid office phone number. Have your Social Security number, birth date, and recent income information ready.

You can also explore online through your state's Medicaid website. Most states now allow online applications. The process usually takes two to four weeks. If you are already receiving Supplemental Security Income (SSI) or Temporary information for Needy Families (TANF), you may be automatically enrolled in Medicaid and should contact your state office to confirm your status.

If you are denied, ask why. Common reasons include income or assets above the limit, or failure to provide required documents. Your state must give you a written explanation and tell you how to appeal the decision.

What happens to your Medicare coverage

Having Medicaid does not change your Medicare enrollment. You remain enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). You still pay the Part B premium each month unless your state Medicaid program pays it for you — many states do pay this premium for dual-may be able to access people.

You can still choose to enroll in Medicare Part D (prescription drug coverage) and a Medigap supplemental plan, though Medicaid may limit which plans you can join. Some states do not allow dual-may be able to access people to have Medigap coverage because Medicaid already covers many of the same costs. Check with your state Medicaid office before enrolling in Part D or Medigap.

If you drop Medicare Part A or Part B, you will lose Medicaid coverage in most states. Medicaid may be able to access is tied to Medicare enrollment. If you later want to re-enroll in Medicare, you may face late penalties and a waiting period.

Common mistakes to avoid

Do not assume you are automatically dual may be able to access just because you turned 65 and enrolled in Medicare. You must meet your state's Medicaid income and asset limits. Many people over 65 have too much income or too many assets to may have access to.

Do not delay explore for Medicaid if you think you might may have access to. Medicaid coverage usually begins the month you are found to be may be able to access, not the month you explore. Some states allow retroactive coverage for up to three months before your process, but this is not may provide.

Do not drop Medicare Part A or Part B to try to lower your income and become Medicaid-may be able to access. This will disqualify you from Medicaid in most states and leave you uninsured. If you are struggling with Medicare premiums, contact your state Medicaid office about programs that pay premiums for low-income seniors.

Do not ignore notices from your state Medicaid office. If Medicaid asks for documents or information, respond within the important date given. Failure to respond can result in loss of coverage.

Frequently Asked Questions

Will Medicaid pay my Medicare Part B premium?

Many states pay the Medicare Part B premium for dual-may be able to access people, but not all. Some states pay it only if your income is below a certain threshold. Contact your state Medicaid office to ask whether premium information is available to you and how to request it.

Can I choose any doctor if I have both Medicare and Medicaid?

If you are in a standard Medicaid program, you can usually see any doctor who accepts both Medicare and Medicaid. If your state requires you to join a managed care plan for dual-may be able to access people, you must use doctors and hospitals in that plan's network, with rare exceptions for emergencies.

What if my income goes above the Medicaid limit?

If your income rises above your state's limit, you will lose Medicaid coverage. Your state will notify you before this happens. You will keep Medicare, but you may want to enroll in a Medigap plan or Medicare Advantage plan to help cover costs Medicaid was paying.

Do I need to report changes to both Medicare and Medicaid?

Report changes to your state Medicaid office. Changes like a move, change in income, or change in household size can affect your Medicaid may be able to access. Medicare does not need to know about these changes unless they affect your Medicare enrollment itself, such as a change in address.

Can I have Medicaid and a Medicare Advantage plan at the same time?

Yes, but your state Medicaid program may limit which Medicare Advantage plans you can join. Some states require dual-may be able to access people to use specific plans designed for them. Ask your state Medicaid office which Medicare Advantage plans are available to you before enrolling.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.