Yes, you can have both Medicare and Medicaid, and millions of people do

Medicare and Medicaid are separate programs run by different parts of the federal government, so there is no rule against holding both. In fact, having both together — called being dual may be able to access — often means lower out-of-pocket costs than Medicare alone, because Medicaid fills gaps that Medicare does not cover.

The catch is that you must meet the income and asset limits for Medicaid in your state, and those limits are strict. Medicare has no income limit at all. So the question is not whether you are allowed to have both, but whether your state's Medicaid program will cover you given what you own and earn.

Key Takeaways

  • You can hold Medicare and Medicaid at the same time if your income and assets fall below your state's Medicaid limits, which vary widely by state.
  • Medicaid covers some costs Medicare does not, including long-term care, dental, and vision, making dual coverage valuable for people with limited resources.
  • Your state determines Medicaid rules, so the income and asset thresholds that make you Medicaid-may be able to access depend on where you live.
  • If you are already on Medicare, you can still explore for Medicaid through your state's Medicaid office or a local social services agency.

How dual coverage works in practice

When you have both programs, Medicare is your primary insurance — it pays first for services it covers. Medicaid then pays some or all of what Medicare does not cover, depending on what your state's Medicaid program includes. This means your share of the bill shrinks.

For example, Medicare covers hospital stays but charges you a deductible and coinsurance. If you are also on Medicaid, Medicaid may pay that deductible and coinsurance for you. Medicare covers some doctor visits but not dental or vision care. Medicaid in many states does cover those services, so you get them through Medicaid instead.

The programs do not merge or communicate automatically. You will have two separate insurance cards and may need to show both when you go to a doctor or hospital. Providers are used to this and know how to bill both programs in the right order.

Income and asset limits that determine whether you may have access to

Medicaid has strict financial thresholds. To be Medicaid-may be able to access, your monthly income must fall below a limit set by your state. For a single person, that limit ranges from about $900 to $1,500 per month depending on the state, though some states use higher thresholds for certain groups. Your state's Medicaid office can tell you the exact number for your situation.

Assets matter too. Most states count how much money you have in the bank, the value of your home (though the home itself is usually exempt), and other property. The asset limit for a single person is often around $2,000 to $3,000, though again this varies by state. If you are married, the limits are higher.

Income includes Social Security, pensions, wages, and some other sources. Some income is not counted — for instance, the first $20 of unearned income per month is usually excluded. Your state's Medicaid office or a local social services worker can walk you through what counts and what does not.

The difference between Medicaid programs for working-age people and seniors

If you are 65 or older and on Medicare, you would be looking at Medicaid for seniors, which has its own rules separate from Medicaid for working-age adults. The income and asset limits are often different, and the services covered may differ too.

Some states have expanded Medicaid to cover more working-age people, but that does not change the Medicaid rules for seniors. If you are over 65 and on Medicare, you explore through your state's Medicaid program for seniors, not the expanded program.

A few states have special programs that combine Medicare and Medicaid benefits into one plan, sometimes called a Medicare-Medicaid plan or dual may be able to access special needs plan. These are optional — you can choose to join one or stick with regular Medicare and Medicaid. Your state's Medicaid office can tell you whether your state offers these plans.

how the process works for Medicaid if you already have Medicare

Start by contacting your state's Medicaid office or your local social services agency. You can find your state Medicaid office through the Centers for Medicare & Medicaid Services website or by calling 211 (a free referral line). Tell them you are already on Medicare and want to know whether you meet the income and asset limits for Medicaid in your state.

You will need to provide proof of income (recent pay stubs, Social Security statements, pension letters), proof of assets (bank statements, property deeds), and proof of citizenship or immigration status. The exact documents vary by state, so ask what your state needs before you gather everything.

Processing times vary. Some states decide within weeks; others take two to three months. Once you are approved, Medicaid coverage usually starts on the first day of the month in which you applied, though some states backdate it further.

Common reasons people are turned down and what to do

The most common reason for denial is income or assets above the state limit. If that happens, you have options. Some states allow you to spend down your assets on medical care or long-term care costs, which lowers your countable assets and can make you Medicaid-may be able to access. Others have programs for people slightly above the limit.

Another reason is citizenship or immigration status. Medicaid requires proof of U.S. citizenship or certain immigration statuses. If you cannot provide that proof, you will be denied, though some states have limited Medicaid programs for immigrants regardless of status.

If you are denied, ask for a written explanation of why. If you believe the decision is wrong — for instance, if the state counted income incorrectly — you have the right to request a hearing. Your state's Medicaid office will explain how to do that.

What happens to your Medicare when you get Medicaid

Nothing changes with your Medicare. You keep your Medicare card, your Medicare coverage, and your Medicare benefits. Medicaid straightforward layers on top of it. You do not have to choose between them or give up one to get the other.

If you lose Medicaid later — for instance, because your income rose — you still have Medicare. If you lose Medicare (which is rare), you can still have Medicaid. The two programs are independent.

Frequently Asked Questions

Does having Medicaid affect my Medicare premiums?

No. Your Medicare Part B and Part D premiums are based on your income and do not change if you also have Medicaid. However, if you are on Medicaid, Medicaid may pay your Medicare premiums for you, which is a major benefit of dual coverage.

Can I have Medicaid in one state and Medicare in another?

Medicare works the same everywhere, so you can use it in any state. Medicaid is state-run, so you must be a resident of the state where you explore. If you move, you will need to explore for Medicaid in your new state.

What if my income is slightly above the Medicaid limit?

Some states have programs for people just above the limit, or allow you to deduct medical expenses from your income to bring it below the threshold. Ask your state's Medicaid office about medically needy programs or income deductions in your state.

Do I need to reapply for Medicaid every year?

Yes. Medicaid requires annual renewal, though many states have extended the renewal period during public health emergencies. You will receive a notice telling you when to renew and what documents to send.

Can I have both Medicare Advantage and Medicaid?

Yes. If you are on a Medicare Advantage plan (Part C) instead of Original Medicare, you can still have Medicaid. Medicaid will work with your Advantage plan the same way it works with Original Medicare, filling in gaps and covering services your plan does not.