Having Both Medicare and Medicaid at the Same Time

Yes, you can have both Medicare and Medicaid

You can hold both Medicare and Medicaid at the same time. In fact, millions of people do. When you have both programs, they work together to cover your medical costs — Medicare is your primary insurance, and Medicaid fills in gaps like copayments, deductibles, and services Medicare does not cover.

People who have both are sometimes called "dual may be able to access" or "dually may be able to access." This usually happens when someone is 65 or older and has a low enough income to also meet Medicaid's income and asset limits. It can also happen if you are under 65, on Social Security Disability Insurance (SSDI), and your income falls below your state's Medicaid threshold.

Key Takeaways

You can be enrolled in both Medicare and Medicaid at the same time, and they coordinate to pay your medical bills.
Most people who have both are 65 or older with income low enough to meet their state's Medicaid limits.
Medicare pays first for covered services, then Medicaid covers what Medicare does not pay, including deductibles and copayments.
Each state sets its own Medicaid income limits, so whether you may have access to depends on where you live and your household income.
You must be enrolled in Medicare Part A and Part B to be considered for Medicaid as a dual-may be able to access person.

How Medicare and Medicaid work together

When you have both programs, the payment order is fixed: Medicare always pays first for any service it covers. Medicaid then pays what Medicare leaves behind — typically your deductible, copayment, or coinsurance amount. This is called "coordination of benefits."

For example, if you see a doctor and Medicare covers the visit but requires a $15 copayment, Medicaid will usually pay that $15. If you need a hospital stay and Medicare covers it but charges you a deductible, Medicaid covers the deductible. Medicaid also pays for services Medicare does not cover at all, such as long-term care in a nursing home or personal care information.

The key requirement is that you must be enrolled in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) before Medicaid will coordinate with it. If you have only Part A or only Part B, you may not be considered dual may be able to access in your state.

Income and asset limits vary by state

There is no single national income limit for Medicaid. Each state sets its own threshold, and it changes year to year. Some states use 100% of the federal poverty level as their limit; others go higher. A few states have different limits depending on whether you are explore as a single person or a couple.

Your state's Medicaid program will count your income — usually Social Security, pensions, wages, and other regular payments — against this limit. Some income sources are not counted, such as Supplemental Security Income (SSI) in certain cases. Asset limits also vary: some states count your savings, investments, and property; others have removed asset limits entirely.

Because the rules differ so much, the only way to know whether your income and assets may have access to you is to contact your state Medicaid office or use your state's online screening tool. Your local Area Agency on Aging can also help you understand your state's specific rules.

Who typically qualifies for both programs

The most common path to having both Medicare and Medicaid is being 65 or older with low income. When you turn 65, you become may be able to access for Medicare regardless of income. If your income is also low enough to meet your state's Medicaid threshold, you can be enrolled in both.

People under 65 can also have both programs if they receive SSDI and their income falls below their state's limit. SSDI recipients automatically may have access to for Medicare after 24 months of receiving benefits, so some people under 65 are already on Medicare when they also meet Medicaid's income test.

A third group includes people who were on Medicaid before turning 65 and remain on it after becoming Medicare-may be able to access. These individuals often stay dual may be able to access because their income has not changed.

How to learn about you may have access to

Start by contacting your state Medicaid office directly. You can find the phone number and website through Medicaid.gov, which has a link to every state program. When you call, have your Social Security number, income information, and asset details ready.

Many states also offer online screening tools that give you a quick answer about whether you might may have access to. These tools ask basic questions about age, income, and household size and tell you whether to file a full process. Some states use a single process for both Medicare and Medicaid, while others require separate applications.

If you are 60 or older, your local Area Agency on Aging can also help you understand whether you may have access to and walk you through the process process. You can find your local agency through the Eldercare Locator at 1-800-677-1116.

What happens after you are enrolled in both

Once you have both Medicare and Medicaid, you will receive a Medicare card and a Medicaid card (or identification number, depending on your state). When you go to a doctor or hospital, show both cards. The provider will bill Medicare first, then submit any remaining balance to Medicaid.

You will still pay Medicare premiums if you are working or have other income — usually deducted from your Social Security check. Medicaid does not charge premiums in most states for people who are dual may be able to access, though some states have small copayments for certain services.

Your coverage will be reviewed periodically — usually once a year — to make sure your income and assets still meet the limits. If your situation changes (you get a raise, receive an inheritance, or move to a different state), tell your Medicaid office right away, because it may affect your coverage.

Special programs for people with both Medicare and Medicaid

Some states offer programs specifically designed for people who are dual may be able to access. These programs, sometimes called "integrated care" or "managed long-term care" programs, combine Medicare and Medicaid services into one plan. Instead of dealing with two separate programs, you get one insurance card and one care coordinator.

These programs are optional — you do not have to join one. If your state offers one and you are automatically enrolled, you have the right to opt out and stay with original Medicare and Medicaid. Ask your state Medicaid office whether such a program exists in your area and whether it makes sense for your situation.

Frequently Asked Questions

Do I have to be on Medicare to get Medicaid?

No. You can have Medicaid without Medicare if you are under 65 and meet your state's income and other requirements. However, if you are 65 or older, you must be enrolled in Medicare Part A and Part B to be considered for Medicaid as a dual-may be able to access person in most states.

What if I turn 65 and I am already on Medicaid?

You will automatically be enrolled in Medicare Part A and Part B when you turn 65, even if you are on Medicaid. Your Medicaid coverage will continue, and the two programs will coordinate. You do not need to do anything — Medicare enrollment happens automatically if you are receiving Social Security.

Can I have Medicare and Medicaid if I live in a state that has not expanded Medicaid?

Yes. Medicaid expansion does not affect people 65 and older. All states cover seniors on Medicaid if their income is low enough, regardless of whether they expanded Medicaid for working-age adults. Your state's income limit for seniors may be different from its limit for younger people.

What if my income goes above the Medicaid limit?

If your income rises above your state's limit, you will lose Medicaid coverage, but you will keep Medicare. You can still use Medicare for your medical care. Some people in this situation look into Medicare Advantage plans or Medigap policies to help cover costs that Medicare does not pay.

Do I need to pay back Medicaid if I receive an inheritance?

It depends on your state and the type of Medicaid services you received. If you received long-term care services and your state has an estate recovery program, Medicaid may try to recover costs from your estate after you pass away. Ask your state Medicaid office about its recovery rules.

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.