Yes, you can have both Medicare and Medicaid

You can hold both Medicare and Medicaid at the same time. In fact, millions of seniors do. When you have both programs, they work together to cover your medical costs — Medicare is your primary insurance, and Medicaid fills in gaps that Medicare does not cover, like copayments, coinsurance, and deductibles. People with both are sometimes called dual may be able to access or dually may be able to access.

Having both programs can significantly reduce your out-of-pocket costs. However, the rules about how they coordinate, and whether you can have both, depend on your state and your income and assets. This matters because the income and asset limits for Medicaid vary widely by state, and some states are more generous than others about letting people keep both programs.

Key Takeaways

  • Medicare and Medicaid can work together, with Medicare paying first and Medicaid covering costs Medicare does not pay.
  • Your state determines whether you can have both programs and sets the income and asset limits that decide who qualifies for Medicaid.
  • Some states have programs specifically designed for people who are dually may be able to access, which may offer additional coverage or lower costs.
  • You must meet your state's Medicaid income and asset limits to hold both programs; exceeding these limits means losing Medicaid even if you keep Medicare.
  • Your Social Security office or state Medicaid agency can tell you whether you meet your state's rules for having both programs.

How Medicare and Medicaid work together

When you have both programs, Medicare is your primary payer. This means Medicare processes your claim first and pays its share of the cost. Medicaid then steps in as the secondary payer and covers what Medicare does not — typically your Medicare copayments, coinsurance, and deductibles.

For example, if you see a doctor and Medicare covers 80 percent of the visit, you would normally owe the remaining 20 percent. If you have Medicaid, Medicaid may pay that 20 percent copayment for you. This coordination reduces what you pay out of pocket, which is why dual coverage is valuable for people on limited incomes.

However, the coordination is not automatic. Your healthcare providers need to know you have both programs so they can bill them in the correct order. When you go to a doctor or hospital, always give them both your Medicare card and your Medicaid card.

Income and asset limits vary by state

To have Medicaid alongside Medicare, you must meet your state's income and asset limits. These limits are different in every state, and some states are much more restrictive than others. A few states use the federal poverty level as their limit; others set their own, sometimes higher and sometimes lower.

Income includes Social Security, pensions, wages, and other regular payments. Assets include savings accounts, investments, and property (though your home and one car usually do not count). If your income or assets exceed your state's limit, you lose Medicaid coverage even if you keep Medicare.

Because limits vary so much, you cannot assume you may have access to in one state if you may have access to in another. If you move, or if your income or assets change, contact your state Medicaid agency to find out whether you still meet the rules. Your state Medicaid office can tell you the exact limits and what counts toward them.

Types of dual-may be able to access programs by state

Some states offer programs specifically for people who are dually may be able to access. These programs coordinate Medicare and Medicaid more closely and may offer additional benefits or lower costs than having the two programs separately. The names and rules differ by state.

Medicaid Savings Programs (also called Medicare Savings Programs or MSPs) help pay your Medicare premiums, deductibles, and copayments if your income is slightly above the regular Medicaid limit. These programs exist in every state but have different income thresholds. may have access to for an MSP does not mean you have full Medicaid coverage — it means Medicaid helps with specific Medicare costs.

Managed long-term care plans (in New York and some other states) combine Medicare and Medicaid into one plan for people who are dually may be able to access. These plans coordinate all your care through a single insurance company and may include services like home care or adult day programs that regular Medicare does not cover.

Other states have programs with different names and structures. Contact your state Medicaid agency or call 1-800-MEDICARE to learn what dual-may be able to access programs exist in your state and whether you meet the rules for each one.

How to learn about you may have access to in your state

The fastest way to learn whether you can have both programs is to contact your state Medicaid agency directly. You can find your state agency through the Centers for Medicare & Medicaid Services website or by calling your state's health department. Have your Social Security number, income information, and a list of your assets ready when you call.

You can also call 1-800-MEDICARE (1-800-633-4227) and ask to speak with someone about dual coverage in your state. They can tell you whether you meet the income and asset limits and direct you to your state Medicaid office to start the process.

If you are already receiving Medicaid and your income or assets change, report the change to your state Medicaid office right away. Failing to report changes can result in overpayments that you may have to repay later.

What happens if your income or assets increase

If your income rises above your state's Medicaid limit, you will lose Medicaid coverage. This can happen if you receive a raise, start a pension, or receive an inheritance. You will keep Medicare, but you will lose the Medicaid coverage that was helping pay your copayments and deductibles.

If this happens, you may be able to switch to a Medicare Savings Program if your income is only slightly above the Medicaid limit. You may also want to look into a Medigap policy (supplemental insurance) to help cover costs that Medicare does not pay. Talk to your state Medicaid office about your options before you lose coverage.

Some people intentionally spend down assets to stay under the Medicaid limit, but this is complicated and has tax and legal consequences. If you are thinking about doing this, speak with an elder law attorney or financial advisor first.

Frequently Asked Questions

Do I have to choose between Medicare and Medicaid?

No. You can have both at the same time if you meet your state's income and asset limits for Medicaid. Having both is common and usually saves you money on healthcare costs.

Will having Medicaid affect my Medicare benefits?

No. Medicare benefits stay the same whether or not you have Medicaid. Medicaid straightforward helps pay costs that Medicare does not cover, like copayments and deductibles.

What if I live in a state with very low Medicaid income limits?

Some states have strict income limits that make it hard to may have access to for Medicaid alongside Medicare. If you do not meet your state's regular Medicaid limit, ask about Medicare Savings Programs, which have higher income thresholds and help pay Medicare costs specifically.

Can I move to another state and keep both programs?

You can move, but you will need to reapply for Medicaid in your new state because each state has different income and asset limits. Contact your new state's Medicaid office as soon as you move to find out whether you still may have access to.

What should I do if I think I may have access to for dual coverage?

Call your state Medicaid agency or 1-800-MEDICARE to learn your state's income and asset limits. Have your Social Security number and income information ready. They can tell you whether you meet the rules and how to proceed.