Yes, you can have both Medicaid and Medicare

You can hold both programs at once. When you do, you are called dual may be able to access. Medicare is federal health insurance based on age or disability. Medicaid is a joint federal-state program based on income and assets. The two programs have different rules, different income limits, and different coverage — so having both means you get coverage from each program for the things each one pays for.

The most common path to dual coverage is reaching age 65 while already on Medicaid. You automatically become may be able to access for Medicare at 65 regardless of income, so if you were on Medicaid before that birthday, you stay on Medicaid and gain Medicare on top. But you can also become dual may be able to access at any age if you may have access to for both programs' separate rules.

Having both programs does not mean you pay nothing. You still pay Medicare premiums, deductibles, and copays. Medicaid may help cover some of those costs, depending on your state and which Medicaid program you are in. The two programs coordinate — Medicare pays first for most services, then Medicaid may cover what Medicare does not.

Key Takeaways

  • Dual may be able to access means you are enrolled in both Medicare and Medicaid at the same time, and each program covers different parts of your medical bills.
  • The most common way to become dual may be able to access is turning 65 while already receiving Medicaid; you keep Medicaid and gain Medicare automatically.
  • You must meet each program's separate income and asset rules — being on one does not automatically put you on the other.
  • Medicare pays first for most services, and Medicaid may cover the costs Medicare leaves behind, such as deductibles and copays.
  • Your state's Medicaid program determines how much help you get with Medicare costs, so coverage varies by location.

How income and asset limits work when you have both

Each program has its own income and asset rules, and you must meet both sets to stay dual may be able to access. Medicare has no income or asset limit — anyone 65 or older, or anyone with certain disabilities, can have it. Medicaid does have income and asset limits, and these vary by state.

If you are on Medicaid and turn 65, you keep your Medicaid as long as your income and assets stay within your state's limits. Your Medicare enrollment does not change your Medicaid status. However, if your income or assets rise above the Medicaid threshold, you can lose Medicaid coverage even though you keep Medicare.

Some states have higher income limits for people over 65 or for people with disabilities. A few states run special Medicaid programs just for people who are dual may be able to access, with different rules than regular Medicaid. Contact your state Medicaid office to learn what limits apply to you.

What each program covers and how they coordinate

Medicare covers hospital stays, doctor visits, prescription drugs (through Part D), and some preventive care. It does not cover long-term care, dental, vision, or hearing aids. Medicaid covers many of those gaps — dental, vision, hearing aids, and nursing home care — but only if your state's Medicaid program includes them.

When you have both programs, Medicare is the primary payer. That means Medicare pays its share of your medical bills first. Medicaid is the secondary payer, meaning it pays after Medicare. For example, if Medicare covers 80 percent of a doctor visit and you owe a 20 percent copay, Medicaid may pay that copay for you — but only if your state's Medicaid program covers it.

Some services are covered by only one program. If Medicare does not cover something but Medicaid does, Medicaid pays. If Medicaid does not cover something but Medicare does, Medicare pays. The programs do not double-pay for the same service.

How to enroll if you become may be able to access for both programs

If you are already on Medicaid and turn 65, you do not need to do anything to get Medicare. You are automatically enrolled in Medicare Parts A and B on the first day of the month you turn 65. You will receive a Medicare card in the mail before your birthday. Your Medicaid coverage continues as long as you still meet your state's income and asset rules.

If you are not yet on Medicaid but become may be able to access for Medicare at 65, you can enroll in Medicare through Social Security. You can sign up online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. At the same time, you can apply for Medicaid through your state's Medicaid office if you think you meet the income limit.

If you are under 65 and disabled, you may be may be able to access for both programs. You would need to be on Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) to may have access to for Medicare as a disabled person. Once you are on SSDI or SSI, you can apply for Medicaid through your state. The rules for disabled people vary by state, so contact your state Medicaid office to learn whether you may have access to.

Medicaid programs designed for dual may be able to access people

Some states run special Medicaid programs for people who are dual may be able to access. These programs are sometimes called Medicare Savings Programs or may have access to Medicare Beneficiary (QMB) programs. They help pay your Medicare premiums, deductibles, and copays.

To be in a Medicare Savings Program, you must have Medicare, be a U.S. citizen or legal resident, and have income below a certain level — usually around 135 to 200 percent of the federal poverty line, depending on the program and your state. Asset limits are also low, usually $7,000 to $11,000 for an individual.

If you are in a Medicare Savings Program, Medicaid pays your Medicare Part B premium directly to Medicare. Depending on which program you are in, Medicaid may also pay deductibles and copays. You do not pay these costs out of pocket. To learn about your state offers this program and whether you meet the income limit, contact your state Medicaid office or call 211.

What happens to your coverage if your income changes

If your income rises above your state's Medicaid limit, you lose Medicaid coverage but keep Medicare. You will still owe Medicare premiums, deductibles, and copays. If you were in a Medicare Savings Program, you lose that help too.

If your income drops back below the Medicaid limit, you can reapply for Medicaid. The time it takes to process your application varies by state, usually between 30 and 45 days. During that time, you have Medicare but not Medicaid. Once you are approved, Medicaid coverage usually starts on the first day of the month you applied or the month after, depending on your state's rules.

Report income changes to your state Medicaid office as soon as they happen. If you do not report a change and you were not supposed to be on Medicaid, your state may ask you to repay benefits you received. If your income drops, reporting quickly means you can get Medicaid back sooner.

Frequently Asked Questions

Do I have to choose between Medicaid and Medicare?

No. You can have both at the same time. You do not choose one or the other. If you are may be able to access for both, you are enrolled in both, and each program pays for different parts of your care.

Will Medicare cost me money if I also have Medicaid?

Yes. You still pay Medicare Part B premiums, deductibles, and copays. Medicaid may help cover some of these costs, but it depends on your state and which Medicaid program you are in. If you are in a Medicare Savings Program, Medicaid pays your Part B premium for you.

What if I turn 65 while on Medicaid?

You automatically enroll in Medicare on the first day of the month you turn 65. You do not need to apply. Your Medicaid stays active as long as your income and assets meet your state's limits. You will receive a Medicare card in the mail.

Can I lose Medicaid if my income goes up?

Yes. Medicaid has income limits that vary by state. If your income rises above the limit, you lose Medicaid coverage. You keep Medicare, but you will owe all Medicare costs yourself unless you may have access to for a Medicare Savings Program.

How do I know if I am dual may be able to access?

You are dual may be able to access if you have both a Medicare card and a Medicaid card. If you are unsure, call your state Medicaid office or your Medicare plan. They can tell you whether you are enrolled in both programs and what coverage you have under each one.