Yes, Medicaid pays Medicare premiums for people who have both programs

If you have both Medicaid and Medicare, your state's Medicaid program will pay some or all of your Medicare premiums, depending on your income and which Medicaid category you fall into. This happens automatically in most cases — you do not have to ask. Medicaid covers the Part B premium (doctor visits), the Part D premium (prescription drugs), and sometimes Part A premiums (hospital care), though the amount varies by state and your specific situation.

The key is that you must be enrolled in both programs at the same time. Medicaid will not pay premiums retroactively if you were not covered when the premium was due. If you are not yet on Medicaid, you need to enroll first; the process differs by state, and some have continuous enrollment while others have open periods.

Key Takeaways

  • Medicaid pays your Medicare Part B and Part D premiums automatically if you may have access to for both programs, with no separate request needed.
  • Your state Medicaid program handles the payment directly to Medicare, so you will not see the premium deducted from your Social Security check.
  • You must be enrolled in Medicaid before the month your premium is due, or Medicaid cannot cover that month's cost.
  • The amount Medicaid covers depends on your income level and which Medicaid category you are in — some people get full coverage, others get partial.
  • If you are not yet on Medicaid, contact your state Medicaid office or call 211 to find out how to enroll in your state.

Which Medicare premiums does Medicaid cover

Medicaid covers the Part B premium, which is the monthly charge for doctor visits and outpatient care. In 2024, the standard Part B premium is $164.90 per month, though it can be higher if your income was above a certain threshold two years ago. If Medicaid covers your Part B, you will not see this amount deducted from your Social Security check.

Medicaid also covers the Part D premium for prescription drug coverage. The amount varies by plan and by state, but Medicaid will pay whatever your chosen plan charges, up to the state's limit. Some states cap what they will pay, so you might owe the difference if you pick an expensive plan.

For Part A (hospital insurance), most people do not pay a premium because they or their spouse paid Medicare taxes while working. However, if you do owe a Part A premium, Medicaid will cover it if you are in a category that includes Part A coverage. Not all Medicaid categories cover Part A premiums, so check with your state program.

How to know if you may have access to for both programs

You may have access to for both Medicaid and Medicare if you meet the income and asset limits for your state's Medicaid program and you are already on Medicare. Income limits vary widely by state — some allow people earning up to 100% of the federal poverty level, others allow up to 200% or more. Asset limits also differ; some states have no asset limit at all.

The easiest way to find out is to contact your state Medicaid office directly. You can also call 211 (a free helpline) and ask to be connected to your state's Medicaid program. Have your Social Security number, income information, and a list of any savings or property ready when you call. They can tell you in one conversation whether you meet the income and asset rules.

If you are already on Medicare and think you might be poor enough for Medicaid, do not wait — contact your state program. Some people delay because they assume they will not may have access to, but the only way to know is to ask. The worst outcome is they say no; the best is you learn you can get help paying premiums.

What happens after Medicaid approves you

Once your state approves you for Medicaid, the program sends your information to Medicare automatically. Medicare then stops deducting your Part B premium from your Social Security check and instead receives payment directly from Medicaid. This usually takes one to two months after Medicaid approval, so you may see one more premium deduction before it stops.

You will receive a notice from Social Security showing that your Part B premium is no longer being deducted. Keep this notice — it proves your premium is being paid. If you see a deduction after you expected it to stop, contact Social Security when ready to report the error.

For Part D, your prescription drug plan will receive notice that Medicaid is covering your premium. You should not see a bill for it. If you do receive a bill after Medicaid approval, contact your drug plan and ask them to verify that Medicaid is paying.

What to do if you are not yet on Medicaid

Contact your state Medicaid office to find out how to enroll. The process varies by state — some allow you to explore online, others require a phone call or in-person visit. You will need to provide proof of income (recent pay stubs, tax returns, or a letter from Social Security showing your benefit amount), proof of citizenship or immigration status, and information about any assets you own.

Processing time ranges from two weeks to two months, depending on your state and how complete your process is. During this time, you are not yet on Medicaid, so Medicaid cannot pay your Medicare premiums. If your Part B premium is due before Medicaid approves you, you will owe it yourself. This is why it is important to explore as soon as you think you might may have access to.

Some states have continuous enrollment, meaning you can explore any time. Others have open enrollment periods, usually once a year. Call your state Medicaid office or 211 to find out whether your state has a important date.

What to do if Medicaid stops paying your premiums

Medicaid coverage can end if your income rises above your state's limit or if you fail to renew your coverage when your state asks you to. If this happens, you will start seeing your Part B premium deducted from your Social Security check again. You will also receive a notice from Medicaid explaining why your coverage ended.

If your income rose slightly above the limit, ask your state Medicaid office whether you can appeal or whether a different Medicaid category might cover you. Some states have categories for people with slightly higher incomes. If your coverage ended because you missed a renewal important date, you can usually reapply when ready.

If you lose Medicaid and cannot afford your Medicare premiums, contact your state Medicaid office again to see if you now may have access to for a different program, such as one for people with disabilities or for seniors with very low income. You can also ask Medicare about Extra Help, a federal program that covers Part D premiums for people with low income.

State-by-state differences in premium coverage

Every state's Medicaid program is different. Some states cover 100% of your Part B and Part D premiums with no limit. Others cover only a portion, or they cap how much they will pay toward Part D. A few states have different rules depending on which Medicaid category you are in — for example, they might cover premiums for seniors but not for people with disabilities.

The only way to know what your state covers is to ask your state Medicaid office. When you call, ask specifically: "Does Medicaid cover my full Part B premium, or do I owe part of it?" and "Is there a limit on how much Medicaid will pay toward my Part D premium?" Write down the answers so you have them in writing.

If you move to a different state, your Medicaid coverage will end in your old state and you will need to enroll in your new state's program. The rules and income limits may be different, so contact your new state's Medicaid office as soon as you move.

Frequently Asked Questions

What if I have Medicare but not Medicaid yet?

You will pay your Part B premium yourself until Medicaid approves you. Contact your state Medicaid office to start the enrollment process. Once approved, Medicaid will pay future premiums, but not past ones you already paid.

Can Medicaid pay back premiums I already paid?

No. Medicaid only pays premiums for months when you are enrolled in both programs. If you paid Part B premiums before Medicaid approved you, that money is gone. This is why explore as soon as you think you may have access to matters.

What if my state Medicaid program says I earn too much?

Ask whether your state has a different Medicaid category you might fit into — some states have programs for people with slightly higher income, or for people with certain disabilities. You can also ask about Extra Help, a federal program for Part D premiums that has higher income limits than Medicaid.

Will Medicaid pay my Part A premium if I owe one?

Only if your Medicaid category includes Part A coverage. Most people do not owe a Part A premium because they paid Medicare taxes while working. Ask your state Medicaid office whether your category covers Part A premiums.

What happens to my premiums if I move states?

Your Medicaid coverage ends when you move, so you will need to enroll in your new state's program. Until you are approved, you will owe your Medicare premiums yourself. Contact your new state's Medicaid office when ready after you move.