Yes, you can have both Medicare and Medicaid
You can hold both Medicare and Medicaid at the same time. In fact, millions of seniors do. When you have both programs, they work together to cover your medical costs — Medicare is your primary insurance, and Medicaid fills in gaps like copayments, deductibles, and services Medicare does not cover. People with both are sometimes called dual may be able to access or dually may be able to access.
Having both programs does not happen automatically. You must meet the rules for each one separately. Medicare is based mainly on age and work history. Medicaid is based on income and assets. This means you could may have access to for Medicare at 65 but not have low enough income for Medicaid, or vice versa. The path to holding both depends on your state, your income, and your assets.
Key Takeaways
- You must meet the separate income and asset limits for both Medicare and Medicaid — may have access to for one does not mean you may have access to for the other.
- Medicaid income limits vary by state and change each year, so the threshold in your state may differ from a neighboring state.
- If you receive Supplemental Security Income (SSI), you are automatically enrolled in your state's Medicaid program when you turn 65.
- You can contact your state Medicaid office directly to ask about income limits and whether you meet them, without starting a formal process.
- Some states have special Medicaid programs designed for people who are already on Medicare and have limited income.
How income and assets affect your Medicaid may be able to access
Medicaid looks at your monthly income and the assets you own. Income includes Social Security, pensions, wages, and interest from savings. Assets include bank accounts, stocks, real estate (except your home in most cases), and vehicles. Each state sets its own income limit for Medicaid, and that limit changes yearly. Some states are more generous than others.
If your income is above your state's limit, you may still may have access to through a process called spend-down. This means you can deduct certain medical expenses from your income to bring it below the threshold. Costs that count toward spend-down include Medicare premiums, copayments, deductibles, and long-term care expenses. The amount you can deduct varies by state.
Asset limits also vary by state. Most states allow you to own a home, one vehicle, and some personal property without it counting against you. Cash, savings accounts, and investments do count. If your assets exceed your state's limit, you will not may have access to for Medicaid unless you can reduce them. Your state Medicaid office can tell you the exact limits that explore where you live.
What happens if you already receive SSI
Supplemental Security Income (SSI) is a federal program for people with very low income and limited assets. If you receive SSI and turn 65, you automatically transition to Supplemental Security Income for Aged, Blind, and Disabled (SSDI-ABD) or remain on SSI. Either way, you are automatically enrolled in your state's Medicaid program. You do not need to explore separately.
This automatic enrollment is one of the clearest paths to holding both Medicare and Medicaid. When you turn 65, Medicare becomes your primary insurance. Your state Medicaid automatically covers the gaps. You should receive a Medicaid card in the mail, but you can also contact your state Medicaid office to confirm your enrollment.
Medicaid programs designed for people on Medicare
Many states offer Medicaid programs specifically for people who are already on Medicare but have limited income and resources. These programs go by different names in different states — some call them Medicare Savings Programs, others call them may have access to Medicare Beneficiary (QMB) programs, and some have their own state-specific names.
These programs typically pay your Medicare Part B premium, and some also cover copayments and deductibles. Income limits for these programs are often higher than for regular Medicaid, which means you might not may have access to for full Medicaid but could still may have access to for one of these narrower programs. Your state Medicaid office can tell you which programs exist in your state and whether your income falls within the range.
To find out what programs your state offers, contact your state Medicaid office directly or call 211 (a free helpline that connects you to local resources). You can also visit your state's Medicaid website. Having the name of your state and your current income will speed up the conversation.
How to learn about you may have access to in your state
The fastest way to learn whether you may have access to for Medicaid is to contact your state Medicaid office. You can ask about income limits, asset limits, and any special programs for people on Medicare without starting a formal process. Many states allow you to ask questions by phone or online without filing anything.
When you call, have your Social Security number, current income (from recent pay stubs or benefit statements), and a list of your assets ready. The staff member can tell you whether your numbers fall within your state's limits. If you are close to the limit, ask about spend-down options or special programs that might help.
You can also visit your state's Medicaid website to look up income limits for the current year. Most states publish these numbers publicly. If you cannot find them online, the Medicaid office can email or mail them to you.
What to do if your income is above the limit
If your income exceeds your state's Medicaid limit, you have a few options. First, ask your state Medicaid office whether you can use spend-down. If you have regular medical expenses — such as ongoing prescriptions, therapy, or equipment — those costs might reduce your countable income enough to may have access to.
Second, look into whether your state offers a Medicaid waiver program or a special program for people with income slightly above the regular limit. Some states have programs for people who work or for people with specific conditions. These programs are less common, but they exist in some states.
Third, if you cannot may have access to for Medicaid, make sure you have a Medigap policy (also called a supplemental insurance policy). Medigap covers many of the costs that Medicare does not, including copayments and deductibles. It is not the same as Medicaid, but it serves a similar purpose for people who do not may have access to for Medicaid.
How Medicare and Medicaid work together when you have both
When you have both programs, Medicare pays first for covered services. Medicaid then pays certain costs that Medicare does not cover, such as copayments, coinsurance, and deductibles. Medicaid may also cover services that Medicare does not, such as long-term care in a nursing home or assisted living facility.
You will use your Medicare card when you see a doctor or go to the hospital. You will also show your Medicaid card. The provider will bill Medicare first, then send the remaining bill to Medicaid. You should not receive a bill for covered services, but if you do, contact both programs to find out why.
Having both programs means you have broader coverage than Medicare alone. Medicaid can help pay for prescription drugs, dental care, vision care, and hearing aids — services that Medicare covers only partially or not at all. The exact coverage depends on your state's Medicaid program.
Frequently Asked Questions
Do I have to choose between Medicare and Medicaid?
No. You can have both at the same time. They are separate programs with different rules, and you can meet the requirements for both. Having both actually gives you more coverage than either program alone.
What is the income limit for Medicaid in my state?
Income limits vary by state and change each year. Your state Medicaid office publishes the current limit on its website or can tell you over the phone. Call your state Medicaid office or visit its website to find the exact number for this year.
If I have a lot of savings, can I still get Medicaid?
Most states have asset limits for Medicaid. If your savings exceed the limit, you may not may have access to unless you can reduce them or use spend-down. Some states allow you to set aside money for future medical care. Ask your state Medicaid office about options specific to your situation.
Will having Medicaid affect my Medicare benefits?
No. Medicaid does not change your Medicare benefits. It works alongside Medicare to cover costs that Medicare does not. You keep all your Medicare coverage and add Medicaid coverage on top.
How do I explore for Medicaid if I think I may have access to?
Contact your state Medicaid office to start the process. You can explore by phone, mail, or online depending on your state. Have your Social Security number, income information, and asset information ready. The office will tell you what documents you need to send.