Can You Have 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 is a federal health insurance program for people 65 and older, regardless of income. Medicaid is a joint federal-state program for people with lower incomes. If you meet the age requirement for Medicare and your income and assets fall within your state's Medicaid limits, you can be enrolled in both at the same time. When you have both, they work together to cover your medical costs — Medicare is your primary insurance, and Medicaid typically covers some of what Medicare does not pay.

People with both programs are sometimes called dual may be able to access or dually may be able to access. This status is common among older adults with limited income and among younger people with disabilities who may have access to for both programs. Having both can mean lower out-of-pocket costs than having Medicare alone, because Medicaid can pay Medicare premiums, deductibles, and copayments.

Key Takeaways

You can hold both Medicare and Medicaid if you meet the age or disability requirements for Medicare and your income and assets are low enough for your state's Medicaid program.
Medicare is your primary payer, meaning it processes your claim first, and Medicaid covers costs Medicare does not pay.
Medicaid can pay your Medicare Part B and Part D premiums, deductibles, and copayments, which can significantly reduce your out-of-pocket expenses.
Each state sets its own Medicaid income and asset limits, so whether you may have access to depends partly on where you live.
You must be enrolled in Medicare Part A and Part B to have Medicaid cover your Medicare costs.

How Medicare and Medicaid work together when you have both

When you receive medical care and have both programs, Medicare processes the claim first. If Medicare covers the service, it pays its share. Then the claim goes to Medicaid, which reviews what Medicare paid and what you still owe. Medicaid can then pay some or all of the remaining balance, depending on what your state's Medicaid program covers and your specific plan.

For example, if you see a doctor and the visit costs $100, Medicare might pay $80 and leave you with a $20 copayment. Medicaid can then pay that $20 copayment, so you pay nothing out of pocket. This coordination happens automatically once both programs know about each other — you do not have to manage the payments yourself.

The same process applies to prescription drugs covered under Medicare Part D. Medicare is the primary payer, and Medicaid can cover the copayments or coinsurance you would otherwise owe.

Income and asset limits vary by state

Medicaid is administered by each state, so the income and asset thresholds that determine whether you may have access to differ depending on where you live. Some states have higher limits than others. Your state's Medicaid program will look at your monthly income and the value of assets you own — such as bank accounts, property, or investments — to decide if you meet the threshold.

Generally, if you are 65 or older and your income is low enough to may have access to for your state's Medicaid program for seniors, you can have both Medicare and Medicaid. If you are younger but have a disability and may have access to for Medicare through Social Security Disability Insurance (SSDI), you may also may have access to for Medicaid if your income and assets are within limits.

To find out your state's specific limits, contact your state Medicaid office or visit your state's Medicaid website. The limits change periodically, so it is worth checking even if you were told you did not may have access to in the past.

You must be enrolled in Medicare Part A and Part B

To have Medicaid cover your Medicare costs, you must be enrolled in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicaid will not pay Medicare premiums or cost-sharing for Part A or Part B if you are not enrolled in both parts.

Most people become may be able to access for Medicare at 65. If you are already receiving Social Security benefits, you are enrolled in Part A and Part B automatically. If you are not receiving Social Security, you must sign up during your initial enrollment period, which begins three months before the month you turn 65 and ends three months after.

If you miss this window, you can still enroll, but you may face a late enrollment penalty on your Part B premium. Medicaid cannot cover a penalty you incur, so enrolling on time matters.

What Medicaid can pay when you have both programs

When you have both Medicare and Medicaid, your Medicaid program can pay several costs that Medicare does not cover or that you would otherwise owe:

Your Medicare Part B monthly premium
Your Medicare Part D (prescription drug) premium
Medicare deductibles for hospital and medical services
Medicare copayments and coinsurance
Services that Medicaid covers but Medicare does not, such as long-term care, dental, or vision care (depending on your state)

The exact amount Medicaid pays depends on your state's program rules. Some states pay the full amount of these costs, while others pay a portion. A few states have programs specifically designed for people who are dually may be able to access, with different cost-sharing rules than standard Medicaid.

How to enroll in both programs

If you are already enrolled in Medicare and think you may may have access to for Medicaid, contact your state Medicaid office to begin the process. You will need to provide information about your income, assets, and household size. The Medicaid office will determine whether you meet your state's limits.

If you are not yet enrolled in Medicare but are approaching 65 and have a low income, you can contact your state Medicaid office before your 65th birthday to ask about Medicaid. Many states will enroll you in Medicaid while you are still working toward Medicare enrollment, so you have coverage in the meantime.

You can also call 1-800-MEDICARE (1-800-633-4227) to learn about Medicare enrollment, or visit Medicare.gov. For Medicaid, search online for your state's Medicaid office or call your state's health department to find the right contact.

What happens if your income or assets change

Medicaid may be able to access is based on your current income and assets, so changes to either can affect whether you stay enrolled. If your income increases above your state's limit, you may lose Medicaid coverage. If your income drops, you may become newly may be able to access.

You are responsible for reporting significant changes to your state Medicaid office. Some changes — such as a change in household size or a job loss — must be reported within a certain timeframe, often 10 days. Failing to report changes can result in overpayments that you may have to repay later.

If you are unsure whether a change affects your Medicaid status, contact your state Medicaid office. They can tell you whether the change matters and what you need to do.

Frequently Asked Questions

Do I have to choose between Medicare and Medicaid?

No. If you meet the requirements for both programs, you can be enrolled in both at the same time. You do not have to pick one or the other. Having both typically costs you less out of pocket than having Medicare alone.

What if I turn 65 but do not yet may have access to for Medicaid?

You can enroll in Medicare at 65 even if you do not may have access to for Medicaid. If your income or assets change later and you become may be able to access for Medicaid, you can enroll then. Medicaid can be added to your Medicare coverage at any time you meet your state's requirements.

Will Medicaid pay for services Medicare does not cover?

Yes, depending on your state. Many state Medicaid programs cover services Medicare does not, such as long-term care, dental work, hearing aids, or eyeglasses. Check with your state Medicaid office to see what additional services are covered under your state's program.

What if I have a Medicare Advantage plan instead of Original Medicare?

Medicaid can still work with a Medicare Advantage plan, but the coordination is different. Some states limit which Medicare Advantage plans you can use if you are also on Medicaid. Contact your state Medicaid office to learn whether your specific plan is compatible with Medicaid coverage in your state.

Can I lose Medicaid if I start working?

If your income from work pushes you above your state's Medicaid limit, you may lose Medicaid coverage. However, many states have work incentive programs that allow you to keep Medicaid even if your income exceeds the normal limit, especially if you have a disability. Ask your state Medicaid office about work incentive programs you might use.

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.