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, Medicaid steps in to help pay costs that Medicare does not cover — like copayments, coinsurance, and premiums. The two programs work together, with Medicare as your primary insurance and Medicaid as a secondary payer.

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 vary by state, and the amount of help you receive depends on your income, assets, and which Medicaid program your state offers.

Key Takeaways

  • Having both Medicare and Medicaid means Medicaid pays some of the costs Medicare does not cover, such as copays and premiums.
  • You must meet your state's income and asset limits for Medicaid while enrolled in Medicare to have both programs.
  • Income limits for dual coverage range from about 75% to 100% of the federal poverty level, depending on your state and which Medicaid program you may have access to for.
  • Your state Medicaid office determines whether you may have access to and what help you receive, so the rules differ by location.
  • If your income or assets change, you should report it to both Medicare and Medicaid to keep your coverage accurate.

How Medicare and Medicaid work together

Medicare pays first for covered services. When you receive care, Medicare pays its share based on what it covers and what you have already paid toward your deductible. Medicaid then pays some or all of what Medicare did not pay — including your copayments, coinsurance, and the Part B premium.

This coordination means you typically pay less out of pocket than you would with Medicare alone. For example, if Medicare covers a doctor visit but charges you a $15 copay, Medicaid may pay that copay for you. If you need a service Medicare does not cover at all, Medicaid may cover it if your state's Medicaid program includes that service.

The exact help you receive depends on which Medicaid program you may have access to for in your state. Some states offer programs specifically designed for people with both Medicare and Medicaid, while others use their standard Medicaid program. Your state determines the scope of coverage.

Income and asset limits by state

To have both Medicare and Medicaid, your income must fall below your state's limit. Most states set the limit at or near the federal poverty level, which changes each year. For 2024, the federal poverty level for a single person is about $15,000 per year, though your state may use a different percentage of this amount.

Some states allow income up to 75% of the federal poverty level, while others permit up to 100% or slightly higher. A few states have higher limits for certain Medicaid programs. You can find your state's current income limit by contacting your state Medicaid office or visiting your state's Medicaid website.

Asset limits also explore in most states. You typically cannot have more than $2,000 in countable assets (for an individual) or $3,000 (for a couple), though some states have higher limits. Countable assets usually include bank accounts, stocks, and bonds. Your home and one vehicle are usually not counted.

If your income or assets exceed the limit by even a small amount, you may not may have access to for Medicaid. Some states offer programs with slightly higher limits for people who are just above the standard threshold — ask your state Medicaid office whether you might may have access to for a different program.

Types of Medicaid programs for people with Medicare

States offer different Medicaid programs for people who also have Medicare. The most common is Medicaid Buy-In, which helps pay your Medicare premiums and cost-sharing. Another option is may have access to Medicare Beneficiary (QMB) coverage, which pays your Part B premium, copayments, and coinsurance. Some states also offer Specified Low-Income Medicare Beneficiary (SLMB) coverage, which pays only your Part B premium.

A few states have programs that go further, such as Medicaid Savings Programs or state-specific dual-may be able to access programs. These may cover additional costs or services beyond what the federal programs cover. Your state Medicaid office can tell you which programs you might may have access to for based on your income and situation.

The program you are placed in depends on your income level and your state's offerings. You do not choose which program; your state determines this when it reviews your case. If your income changes, you may move to a different program or lose Medicaid coverage altogether.

How to learn about you may have access to in your state

Contact your state Medicaid office directly. You can find the phone number and website by searching "[your state] Medicaid" or by calling 1-800-MEDICARE and asking for your state Medicaid office number. Have your Social Security number, income information, and a list of your assets ready when you call.

You can also visit your local Medicaid office in person if you prefer to speak with someone face-to-face. Many offices accept walk-ins, though some require an appointment. Bring documents that show your income (such as recent pay stubs or tax returns) and your assets (such as bank statements).

If you are already receiving Medicaid in your state, you may already be enrolled in one of the dual-may be able to access programs. Check your Medicaid card or call the number on it to confirm your coverage type. If you are not sure whether you have Medicaid, call your state Medicaid office and give them your name and Social Security number.

What happens if your income or assets change

You must report changes to both Medicare and Medicaid. If your income increases, you may no longer may have access to for Medicaid, or you may move to a different program with less help. If your income decreases, you may become newly may be able to access or move to a program with more coverage.

Report changes to your state Medicaid office as soon as they happen. Most states allow you to report by phone, mail, or online through your state's benefits portal. Keep records of the change (such as a letter from your employer or Social Security) in case Medicaid asks for proof.

If Medicaid coverage ends because your income is too high, you can still keep Medicare. You will pay the full cost of Medicare premiums and cost-sharing on your own, but your Medicare coverage continues. Some people in this situation look into Medicare Advantage or Medigap plans to help with costs.

Questions to ask your doctor and Medicaid office

Ask your state Medicaid office: "Which Medicaid program am I in, and what costs does it cover?" and "What is the income limit, and what counts as income for this program?" Also ask: "If my income changes, how do I report it, and how long does it take to update my coverage?"

Ask your doctor's office: "Do you accept Medicaid?" Some providers accept Medicare but not Medicaid, or they accept Medicaid only for certain services. Confirm that your providers accept both programs before you receive care, so you know what you will owe.

If you are denied Medicaid coverage, ask: "Can I appeal this decision, and what do I need to provide?" Most states allow you to request a hearing if you disagree with a denial. Your state Medicaid office can explain the appeal process.

When to contact Medicare or Medicaid

Contact your state Medicaid office right away if your income or assets change, if you move to a different state, or if you are denied coverage and want to appeal. Also reach out if you receive a notice saying your Medicaid coverage will end — you may be able to request a hearing before it stops.

Contact Medicare (1-800-MEDICARE) if you have questions about what Medicare covers or if you need help understanding a bill. Contact your state Medicaid office if you have questions about what Medicaid covers or if you need help paying a bill that Medicare did not fully cover.

If you are having trouble affording care even with both programs, ask your provider about financial information programs or sliding-scale fees. Many hospitals and clinics offer additional help for people with low income.

Frequently Asked Questions

What if I move to a different state?

Your Medicaid coverage ends when you move. You must explore for Medicaid in your new state, which has its own income limits and programs. Contact your new state's Medicaid office within 30 days of moving to start the process. Your Medicare coverage continues regardless of where you live.

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

Yes. If you have both Medicare and Medicaid, you can enroll in a Medicare Advantage plan instead of Original Medicare. Medicaid will still help pay your cost-sharing. Some Medicare Advantage plans are designed specifically for people with both Medicare and Medicaid and may offer extra benefits.

Does having Medicaid affect my Medicare benefits?

No. Medicaid does not change what Medicare covers. It only helps pay the costs that Medicare does not cover. Your Medicare benefits remain the same whether or not you have Medicaid.

What if my income is just slightly above the limit?

Contact your state Medicaid office anyway. Some states have programs with higher income limits or special rules for people just above the standard threshold. You may may have access to for a different program even if you do not may have access to for the main one.

How long does it take to learn about I may have access to?

Most states process Medicaid applications within 30 to 45 days, though some are faster. If you are already receiving Medicare and have low income, your state may be able to process your process more quickly. Ask your state Medicaid office for an estimate when you explore.