Yes, you can have both Medicare and Medicaid coverage at once
You can hold both Medicare and Medicaid at the same time. In fact, millions of people do. When you have both programs, you are called dual may be able to access. Medicare is your federal health insurance based on age or disability; Medicaid is your state's program for people with low income or limited resources. The two programs work together, with Medicare as your primary payer and Medicaid as your secondary payer in most cases.
Being dual may be able to access means you have more coverage than someone on Medicare alone. Medicaid typically covers costs that Medicare does not — like long-term care, dental work, and vision care — and it also pays some of the out-of-pocket costs Medicare requires, such as deductibles and copayments. However, the exact coverage you receive depends on which state you live in, because Medicaid rules vary by state.
Key Takeaways
- Dual may be able to access means you are enrolled in both Medicare and Medicaid at the same time, and Medicaid covers gaps that Medicare leaves.
- You become dual may be able to access automatically if you meet both programs' income and resource limits, though you may need to enroll in a Medicare plan if you have not already.
- Medicaid covers services Medicare does not, including long-term care, dental, vision, and hearing aids in most states.
- Your state Medicaid office determines your exact benefits, so what Medicaid covers for you depends on where you live.
- Some states offer special Medicaid plans designed for dual may be able to access people that coordinate care between the two programs.
How you become dual may be able to access
You become dual may be able to access when you meet the income and resource limits for both Medicare and Medicaid. You do not need to do anything special to trigger dual may be able to access — it happens automatically once you may have access to for both programs. However, the process differs slightly depending on whether you already have Medicare.
If you are already on Medicare and your income drops or your resources fall below your state's Medicaid limit, you can contact your state Medicaid office to request a Medicaid information. You will need to provide proof of income (tax returns, Social Security statements, or pay stubs) and a list of your resources (bank accounts, property, investments). Your state will then tell you whether you meet the threshold. If you are not yet on Medicare but you are 65 or older, you can enroll in Medicare through Social Security while simultaneously explore for Medicaid through your state office.
Income and resource limits vary by state. Some states use the federal poverty level as their cutoff; others set their own, higher thresholds. Contact your state Medicaid office or call 211 to find out the exact limits where you live.
What Medicaid covers that Medicare does not
Medicare covers hospital stays, doctor visits, and some preventive care, but it has significant gaps. Medicaid fills many of those gaps for dual may be able to access people. The most important difference is long-term care: Medicare does not pay for nursing home care or in-home personal care services, but Medicaid does — and this is often the reason people become dual may be able to access in the first place.
Medicaid also covers dental work, vision care (including glasses and eye exams), and hearing aids in most states, none of which Medicare covers. It pays for transportation to medical appointments, which Medicare does not. In many states, Medicaid covers prescription drugs that Medicare's Part D does not, and it may cover over-the-counter items like incontinence supplies and diabetic testing supplies.
Medicaid also pays some of your Medicare costs. It can cover your Medicare Part B premium (currently $164.90 per month for most people in 2024, though this amount changes yearly), your Part A deductible, and your copayments for doctor visits and hospital stays. This is called cost-sharing, and it can save you hundreds of dollars per year.
Income and resource limits by state
Each state sets its own income and resource limits for Medicaid. There is no single national threshold. Some states are more generous than others, and some have waiting lists for certain services.
| Limit Type | What It Means | How It Varies |
|---|---|---|
| Income limit | The monthly income you can have and still may have access to for Medicaid | Ranges from about 75% of federal poverty level to 300% or higher, depending on state |
| Resource limit | The total value of your savings, investments, and property you can own | Typically $2,000 for an individual, but some states allow more; home and one vehicle usually do not count |
| Spousal protections | Rules that protect a healthy spouse's income and resources when one spouse needs Medicaid | Vary widely; some states allow the healthy spouse to keep more income and resources than others |
To find your state's exact limits, contact your state Medicaid office directly or call 211 and ask for Medicaid information. You can also visit your state health department website, which usually has a Medicaid section with current income and resource thresholds.
How Medicare and Medicaid work together when you need care
When you are dual may be able to access and you receive medical care, the two programs coordinate payment. Medicare pays first, up to what it covers. Medicaid then pays what Medicare does not cover, including deductibles, copayments, and services Medicare excludes entirely.
For example, if you see a doctor and Medicare covers 80% of the visit cost, you would normally owe 20%. If you are dual may be able to access, Medicaid pays that 20% copayment. If you need a service Medicare does not cover at all — like dental work — Medicaid pays for it directly (if your state's Medicaid plan includes dental coverage).
This coordination means you should never receive a bill for a covered service. If you do, contact both Medicare and your state Medicaid office to report it. Keep all bills and explanations of benefits (EOBs) from both programs so you can track what each one paid.
Medicaid plans for dual may be able to access people
Some states offer special Medicaid managed care plans designed specifically for people who are dual may be able to access. These plans coordinate your Medicare and Medicaid benefits in one place, which can make it easier to manage your care. They are sometimes called D-SNPs (Dual may be able to access Special Needs Plans) or integrated plans.
If your state offers a D-SNP, you can choose to enroll in one, but you do not have to. You can stay on Original Medicare and your state's Medicaid program separately if you prefer. D-SNPs often include extra benefits like dental, vision, or transportation, but they also require you to use doctors and hospitals in their network. Before enrolling in a D-SNP, compare it to your current coverage to make sure you are not losing access to a doctor you want to keep.
To find out whether your state offers D-SNPs and what they cover, contact your state Medicaid office or call Medicare at 1-800-MEDICARE.
What you need to know about Medicare premiums and Medicaid
If you are dual may be able to access, Medicaid typically pays your Medicare Part B premium for you. This is called a Part B premium subsidy. You do not pay it yourself; Medicaid sends the payment directly to Medicare on your behalf.
However, you are still responsible for your Medicare Part A premium if you did not pay into Social Security long enough to may have access to for premium-free Part A. In that case, Medicaid may pay your Part A premium as well, depending on your state's rules. Ask your state Medicaid office whether your Part A premium is covered.
Your Medicare Part D prescription drug coverage works alongside Medicaid. If you are dual may be able to access, you must enroll in a Part D plan, and Medicaid will help pay for your drugs. Some states have their own rules about which Part D plans dual may be able to access people can join, so check with your state Medicaid office before choosing a plan.
Frequently Asked Questions
What happens to my Medicaid if my income goes up?
If your income rises above your state's Medicaid limit, you will lose Medicaid coverage. However, you will keep Medicare. Some states have programs that let you keep Medicaid for a few months even if your income temporarily exceeds the limit, so contact your state Medicaid office to ask about work incentives or income disregards if your situation changes.
Can I have Medicare Advantage and Medicaid at the same time?
Yes. If you are dual may be able to access, you can enroll in a Medicare Advantage plan (Part C) instead of Original Medicare. However, some Medicare Advantage plans are designed specifically for dual may be able to access people (D-SNPs), while others are not. Before enrolling in a Medicare Advantage plan, confirm that it works well with your state's Medicaid program and that your doctors are in the network.
Do I have to enroll in Medicaid if I am on Medicare?
No, enrollment is not automatic. You must contact your state Medicaid office and request a information. However, if you meet the income and resource limits, you should enroll because Medicaid covers costs Medicare does not and can save you significant money on out-of-pocket expenses.
What if I move to a different state?
Your Medicaid coverage ends when you move, because each state runs its own program. You will keep Medicare, but you must explore for Medicaid in your new state. Contact your new state's Medicaid office within 30 days of moving to start the process. Income and resource limits may be different in your new state, so you may or may not may have access to.
Can my spouse be dual may be able to access if I am?
Your spouse can be dual may be able to access if they meet the income and resource limits for both Medicare and Medicaid. However, spousal income and resources are counted differently depending on your state and whether you are explore together or separately. Contact your state Medicaid office to understand how your household's income and resources will be evaluated.