How to Enroll in Medicare and Medicaid at the Same Time

Medicare and Medicaid are separate programs with different enrollment paths

Medicare and Medicaid are two different government health insurance programs, and you can be enrolled in both at the same time. Medicare is a federal program based mainly on age or disability status. Medicaid is a state program based mainly on income. If you meet the requirements for both, you may be able to have coverage under each one — people with both are sometimes called "dual may be able to access."

The way you enroll in each program is different. You do not explore for both in one place or on one form. You will need to contact Medicare through one route and Medicaid through another, because they are run by different agencies in different ways.

Whether you can have both depends on where you live, your age, your income, and your disability status. Some people are automatically enrolled in both. Others have to take steps to enroll in one or both programs.

Key Takeaways

Medicare enrollment happens through Social Security or Medicare.gov, while Medicaid enrollment happens through your state's Medicaid office or health insurance marketplace.
You can be enrolled in both Medicare and Medicaid at the same time if you meet the income and other requirements for each program.
If you turn 65, you have a three-month window before and after your birthday to enroll in Medicare without a late penalty.
Some states automatically enroll people in Medicaid when they turn 65 and may have access to for Medicare, but you should confirm this with your state Medicaid office.
Your state Medicaid office can tell you whether you may be able to have both programs and what documents you will need to provide.

How to enroll in Medicare

You become may be able to access for Medicare at age 65. You can enroll starting three months before your 65th birthday and continuing for three months after. If you do not enroll during this window, you may pay a higher premium for as long as you have Medicare.

To enroll in Medicare, you have three main options. You can go to Medicare.gov and enroll online. You can call 1-800-MEDICARE (1-800-633-4227) and enroll by phone. Or you can visit your local Social Security office in person. Social Security handles Medicare enrollment, so you can also enroll when you explore for Social Security retirement benefits.

You will need your Social Security number and information about your current health coverage, if you have any. If you are already receiving Social Security benefits, you may be automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance) when you turn 65. You can check your enrollment status on Medicare.gov or by calling the number above.

How to enroll in Medicaid

Medicaid rules and income limits are different in every state. Some states have expanded Medicaid to cover more people. Others have not. Your state determines whether you can enroll in Medicaid based on your income, age, disability status, and family size.

To find out how to enroll in your state's Medicaid program, contact your state Medicaid office directly. You can find your state office through Medicaid.gov, which has a link to each state's program. You can also call 211 and ask for your state Medicaid office phone number — 211 is a free helpline that connects you to local health and human services.

When you contact your state Medicaid office, ask them directly: "Can I have both Medicare and Medicaid?" and "What do I need to do to enroll?" They will tell you whether you meet the income and other requirements, and what documents to bring or mail in. Some states let you enroll online. Others require you to mail in a form or visit an office in person.

What documents you may need for each program

For Medicare, have your Social Security number ready. If you are not yet receiving Social Security benefits, you will need to provide proof of citizenship or legal residency — a birth certificate, passport, or naturalization papers work. You will also need information about any current health coverage.

For Medicaid, requirements vary by state, but most states ask for proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of residency (a utility bill or lease), and proof of citizenship or legal residency. Some states also ask for information about your assets or savings. Call your state Medicaid office before you gather documents — they will tell you exactly what they need.

If you are explore for both programs, keep copies of everything you submit. You may need to show the same documents to both Medicare and Medicaid, or to prove to one program that you are already enrolled in the other.

When you might be automatically enrolled in both programs

If you are already receiving Medicaid when you turn 65, some states automatically enroll you in Medicare Part A at the same time. However, not all states do this, and the process varies. You should contact your state Medicaid office before you turn 65 to ask whether they will automatically enroll you in Medicare, or whether you need to take steps yourself.

If you are receiving Supplemental Security Income (SSI) — a federal program for people with very low income — you may be automatically enrolled in both Medicare and Medicaid when you turn 65. Again, this depends on your state. Confirm with your state Medicaid office and with Social Security.

Even if you think you might be automatically enrolled, it is worth calling to confirm. Enrollment mistakes happen, and it is better to know before a bill arrives or a claim is denied.

What happens after you enroll in both programs

Once you are enrolled in both Medicare and Medicaid, Medicare is your primary insurance. This means Medicare pays first on your medical bills. Medicaid is your secondary insurance and may pay some costs that Medicare does not cover — such as copayments, coinsurance, or deductibles. Medicaid may also cover services that Medicare does not, depending on your state.

You will receive a Medicare card in the mail. You will also receive a Medicaid card or information about your Medicaid coverage from your state. Bring both cards to every doctor's appointment and when you fill prescriptions. Tell your doctor and pharmacist that you have both programs so they bill correctly.

Your coverage and costs may change from year to year. Medicare reviews your coverage every year during Open Enrollment, which runs from October 15 to December 7. Your state Medicaid program may also have annual reviews. Mark these dates on your calendar and check your coverage each year to make sure it still meets your needs.

What to do if you are denied or have questions

If your Medicaid process is denied, your state Medicaid office must send you a written notice explaining why. The notice will also tell you how to request a hearing to appeal the decision. You usually have 30 to 60 days to file an appeal, depending on your state. Keep the denial letter and call your state Medicaid office to ask about the appeal process.

If you have questions about Medicare enrollment or coverage, call 1-800-MEDICARE. If you have questions about Medicaid, call your state Medicaid office. If you are not sure which program should be paying for something, or if you received a bill you think is wrong, ask to speak with a benefits counselor. Many states offer free counseling through the State Health Insurance information Program (SHIP). You can find your state SHIP by calling 1-877-839-2675.

Frequently Asked Questions

Can I enroll in Medicaid before I turn 65?

Yes. Medicaid is not based on age — it is based on income and other factors that vary by state. You can enroll in Medicaid at any age if you meet your state's requirements. When you turn 65, you will enroll in Medicare separately, and you may be able to keep your Medicaid coverage at the same time.

What if my income is too high for Medicaid but I cannot afford Medicare premiums?

You may be able to get help paying Medicare premiums through a program called may have access to Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB). These programs have different income limits than Medicaid. Contact your state Medicaid office and ask whether you may have access to for either program.

Do I have to enroll in Medicare Part B, or can I just have Part A?

You can enroll in Part A only, but if you wait to enroll in Part B later, you may pay a higher premium for the rest of your life. If you are still working and have health coverage through your job, you may be able to delay Part B without a penalty — ask Social Security about this before you turn 65.

What if I move to a different state?

Medicare coverage stays the same no matter where you live. Medicaid coverage changes when you move because each state has different rules and income limits. Contact your new state's Medicaid office within 30 days of moving to find out whether you still may have access to and what you need to do to transfer your coverage.

Can I have Medicare and Medicaid if I am not a U.S. citizen?

You must be a U.S. citizen or have been a lawful permanent resident for at least five years to enroll in Medicare. Medicaid rules for non-citizens vary by state. Contact your state Medicaid office to ask what documentation you need and whether you are able to enroll.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.