Having Both Medicare and Medicaid at the Same Time

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

You are not forced to choose between them. Medicare and Medicaid serve different purposes — Medicare is based on age or disability status regardless of income, while Medicaid is based on income and assets. If you meet the requirements for both programs, you can be enrolled in both at the same time. People with both are sometimes called "dual may be able to access" or covered by "Medi-Medi" plans.

Having both programs means your medical bills get paid by two different sources. Medicare typically pays first for services it covers, and Medicaid can cover costs Medicare does not pay, like copayments, coinsurance, and services Medicare does not include. This layering of coverage can significantly reduce your out-of-pocket costs.

Key Takeaways

You can hold both Medicare and Medicaid at the same time if you meet income and other requirements for Medicaid while also may have access to for Medicare through age, disability, or end-stage renal disease.
Medicare pays first for covered services, and Medicaid can then pay your remaining costs like copayments and deductibles that Medicare does not cover.
Your state determines Medicaid income limits, so whether you can have both depends partly on where you live.
Dual-may be able to access people often pay less out of pocket than people with Medicare alone, but you must stay enrolled in both programs to keep this benefit.

Who qualifies for both programs

To have both Medicare and Medicaid, you must first meet Medicare's requirements. This means you are 65 or older, or you are under 65 with a disability that Social Security has recognized, or you have end-stage renal disease. Medicare does not check your income — only your age or disability status matters.

You must also meet your state's Medicaid income and asset limits. Each state sets its own thresholds, and they vary widely. Some states allow people with higher incomes to keep Medicaid if they have high medical expenses; others have stricter cutoffs. Your state's Medicaid office can tell you the exact income limit that applies to you.

If you are already receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you may already may have access to for Medicaid in your state. Check with your state Medicaid program to confirm your status.

How the two programs work together

When you have both programs, the order of payment matters. Medicare is the primary payer, meaning it processes your claim first and pays its share of covered services. Medicaid then becomes the secondary payer and can cover costs that Medicare did not pay.

For example, if you see your doctor and Medicare covers the visit but requires a $15 copayment, Medicaid may pay that copayment for you. If you need a service that Medicare does not cover but Medicaid does — such as dental care or long-term care in some states — Medicaid can pay for that service directly. This coordination reduces what you owe out of pocket.

Your provider submits claims to Medicare first. Once Medicare processes the claim and sends its payment, the provider or Medicaid receives the explanation of benefits and submits the remaining balance to Medicaid. This process usually happens automatically, though you should verify that both programs are listed on your insurance cards and in your medical records.

Income limits and how they work by state

Medicaid income limits for people who also have Medicare vary by state. Some states use the federal poverty level as their cutoff; others allow higher incomes. A few states have special programs for people with Medicare who have slightly higher incomes but cannot afford their Medicare premiums and cost-sharing.

These special programs include the may have access to Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the may have access to Individual (QI) program. Each has its own income limit, usually set at a percentage of the federal poverty level. Your state Medicaid office determines whether you meet the requirements and which program you can join.

To find your state's specific income limits, contact your state Medicaid office directly or visit your state's Medicaid website. You can also call 1-800-MEDICARE to ask about your state's programs for people with both Medicare and Medicaid.

What happens to your Medicare coverage

Having Medicaid does not change how Medicare works. You still pay Medicare Part B premiums (unless Medicaid pays them for you through one of the programs mentioned above), and you still have the same coverage for hospital care, doctor visits, and other services Medicare includes. Your Medicare benefits remain exactly the same.

If you are enrolled in a Medicare Advantage plan (Part C), you can still have Medicaid. Medicaid will coordinate with your Medicare Advantage plan the same way it does with Original Medicare. Some states offer special dual-may be able to access plans that combine Medicare and Medicaid benefits into one plan, which can simplify your coverage, but these are optional.

How to enroll or verify your coverage

If you already have Medicare and think you might may have access to for Medicaid, contact your state Medicaid office to start the process. You will need to provide proof of income, assets, and citizenship. The application process and required documents vary by state.

If you are already receiving Medicaid and turn 65, you will automatically become may be able to access for Medicare. You should enroll in Medicare Part A and Part B during your Initial Enrollment Period, which begins three months before the month you turn 65. Your Medicaid coverage will continue while you enroll in Medicare.

You can verify your current coverage by checking your Medicare card and your Medicaid card or letter. Both should be active and current. If you have questions about whether you are enrolled in both programs, call your state Medicaid office or 1-800-MEDICARE.

What you need to know about staying enrolled

To keep both Medicare and Medicaid, you must maintain your may be able to access for both programs. This means your income and assets must stay below your state's Medicaid limits, and you must continue to meet Medicare's requirements (which do not change if you are 65 or older or have a recognized disability).

Your state may require you to recertify your Medicaid may be able to access periodically — usually once a year or every few years, depending on the state. You will receive a notice in the mail asking you to provide updated income and asset information. Respond to these notices on time, or your Medicaid coverage could end even if you still may have access to.

If your income increases above your state's limit, you may lose Medicaid but keep Medicare. If this happens, you can still get help paying Medicare costs through the programs mentioned earlier (QMB, SLMB, QI) if your income is not too high.

Frequently Asked Questions

Do I have to pay premiums for both Medicare and Medicaid?

Medicare Part A is usually free if you or your spouse paid Medicare taxes while working. Medicare Part B has a monthly premium that varies by income. Medicaid has no premiums. If you have both programs and your income is very low, Medicaid may pay your Medicare Part B premium for you through the QMB program.

What if I move to a different state?

Your Medicare coverage follows you to any state, but Medicaid does not. You must apply for Medicaid in your new state, which has its own income limits and rules. Contact your new state's Medicaid office within 30 days of moving to start the process.

Can I use any doctor if I have both programs?

Most doctors accept both Medicare and Medicaid, but not all do. Ask your doctor's office before your visit whether they accept both programs. If you are in a Medicare Advantage plan, you may have a network of doctors you must use, and Medicaid will coordinate with that network.

What if Medicaid says I make too much money?

If your income is slightly above your state's Medicaid limit, you may still may have access to for QMB, SLMB, or QI programs, which help pay Medicare costs. These programs have higher income limits than regular Medicaid. Ask your state Medicaid office which program you might may have access to for.

Does having both programs affect my Social Security benefits?

No. Your Social Security benefits are separate from Medicare and Medicaid. Having both programs does not change how much Social Security you receive or when you can receive it.

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.