Yes, you can have both Medicare and Medicaid, and many people do

Medicare and Medicaid are separate programs that work together. Medicare is federal health insurance based on age or disability. Medicaid is a joint federal and state program based on income and assets. You do not have to choose one or the other — you can be covered by both at the same time. People with both are called dual may be able to access.

Having both programs means Medicare is your primary insurance and Medicaid is your secondary. Medicare pays first for covered services. Medicaid then covers costs Medicare does not pay, like copayments, coinsurance, and deductibles. In some cases, Medicaid also covers services Medicare does not cover at all, such as long-term care in a nursing home.

Whether you can have both depends on whether you meet the income and asset limits for Medicaid in your state. Medicare has no income limit — if you are 65 or older, or disabled and have worked long enough, you may have access to regardless of how much money you have. But Medicaid does have limits, and those limits vary by state.

Key Takeaways

  • You can have Medicare and Medicaid at the same time if your income and assets fall below your state's Medicaid limits.
  • Medicare pays first for covered services, and Medicaid covers the costs Medicare leaves behind, like deductibles and copays.
  • Income limits for Medicaid vary by state, so you need to check your specific state's rules, not national figures.
  • If you have both, you may have access to services like nursing home care that Medicare alone does not cover.
  • You do not automatically get Medicaid when you turn 65 or enroll in Medicare — you must explore separately to your state Medicaid program.

How income and asset limits work for dual coverage

Each state sets its own income and asset limits for Medicaid. Some states are more generous than others. For example, one state might allow a single person with $1,000 per month in income to may have access to, while another allows $2,500. The same variation applies to assets — how much money or property you can own and still may have access to.

Your income includes Social Security, pensions, wages, and interest from savings. Your assets include bank accounts, stocks, real estate (except your primary home in most cases), and vehicles. Some assets do not count — your home, one car, and personal belongings usually do not affect your Medicaid decision.

To find your state's exact limits, contact your state Medicaid office directly or visit your state health department website. You can also call 211 and ask for Medicaid information for your state. Do not rely on national averages — your state's rules are what matter.

What happens to your Medicare coverage when you get Medicaid

Getting Medicaid does not change your Medicare coverage. You keep your Medicare card and your Medicare benefits. What changes is how bills get paid. When you see a doctor or go to the hospital, Medicare still processes the claim first. Then Medicaid steps in to cover what Medicare did not pay.

This matters most for costs that add up. If Medicare requires you to pay a $200 deductible and 20 percent coinsurance on a hospital stay, Medicaid can cover those amounts. Without Medicaid, you would owe them yourself. With Medicaid, you may owe nothing or a small copay depending on your state's rules.

Some doctors and hospitals accept both Medicare and Medicaid. Others accept only Medicare. When you have both, your options are usually wider because providers know Medicaid will cover what Medicare does not.

how the process works for Medicaid while you have Medicare

You explore for Medicaid through your state, not through Medicare or the federal government. Each state runs its own Medicaid program, so the process process varies. Most states let you explore online, by mail, or in person at a local office.

Start by finding your state Medicaid office. Search "[your state] Medicaid" or visit your state health department website. You can also call 211 and ask for the Medicaid office phone number in your area. When you call or visit, tell them you have Medicare and want to know if you can also get Medicaid based on your income and assets.

You will need to provide proof of income (pay stubs, Social Security statements, tax returns), proof of assets (bank statements), and proof of citizenship or immigration status. Have your Medicare card handy when you explore — it shows you already have federal health insurance, which speeds up the process.

Processing time varies by state, but most decisions come within 30 to 45 days. Some states are faster. Ask when you explore how long it typically takes in your area.

Special Medicaid programs for people with Medicare

Some states offer programs specifically designed for people who have both Medicare and Medicaid. These programs are sometimes called Medicare Savings Programs or Medicaid Buy-In programs. They help pay your Medicare premiums, deductibles, and copays.

The Medicare Savings Program is available in every state and helps pay your Part B and Part D premiums. To may have access to, your income must be between 120 and 200 percent of the federal poverty level, depending on which program you enter. Asset limits are also higher than regular Medicaid — usually around $7,000 for a single person.

Some states also have programs that let working people with disabilities keep Medicaid even if their earnings would normally disqualify them. These are called Medicaid Buy-In programs. If you are under 65 and working, ask your state Medicaid office whether you may have access to.

What Medicaid covers that Medicare does not

Medicare covers hospital stays, doctor visits, and some skilled nursing care. It does not cover long-term care in a nursing home, assisted living, or home health aides for personal care. Medicaid does cover these services, which is one of the biggest reasons people with Medicare also need Medicaid.

If you need to move to a nursing home, Medicare will pay for up to 100 days of skilled nursing care after a hospital stay of at least three days. After that, you pay out of pocket unless Medicaid covers you. With Medicaid, you can stay in a nursing home indefinitely, though you may have to spend down your assets first.

Medicaid also covers dental care, vision care, and hearing aids in many states — services Medicare does not cover. It covers prescription drugs through its own program, separate from Medicare Part D. If you have both, you usually stay in Medicare Part D for drug coverage, but Medicaid can help pay the premiums and copays.

What to do if your income or assets change

If your income or assets increase, you must report the change to your state Medicaid office. If you go over the limit, you will lose Medicaid coverage. The timing of when you lose coverage depends on your state — some end it when ready, others give you a grace period.

If your income or assets decrease, report that too. You may become newly may be able to access for Medicaid or move into a higher income tier that gives you more coverage. Do not wait for your annual renewal — report changes as soon as they happen.

Keep records of any changes: a new job, a raise, a pension increase, the sale of property, or a large gift. When you report, have documentation ready. Your state Medicaid office will tell you what counts as a reportable change and how to report it.

Frequently Asked Questions

Do I automatically get Medicaid when I turn 65 and get Medicare?

No. Medicare and Medicaid are separate programs. Turning 65 and enrolling in Medicare does not automatically enroll you in Medicaid. You must explore to Medicaid separately through your state. Many people assume they are automatically covered by both, so check with your state Medicaid office to be sure.

If I have both Medicare and Medicaid, do I need a Medigap plan?

No. Medicaid covers the costs that Medigap would cover — deductibles, copays, and coinsurance. Having both Medicare and Medicaid is better than having Medicare and Medigap because Medicaid also covers services Medigap does not, like nursing home care. You do not need all three.

What if my state did not expand Medicaid?

Some states have not expanded Medicaid under the Affordable Care Act, which means income limits are lower. If you are under 65 and not disabled, you may not may have access to even if your income is low. If you are 65 or older, you may still may have access to under your state's regular Medicaid program for seniors. Contact your state Medicaid office to find out what limits explore to you.

Can I have Medicare, Medicaid, and private insurance at the same time?

You can have Medicare and Medicaid together, but you should not also have private insurance from an employer or the marketplace. Having both Medicare and Medicaid already covers your health care, and adding private insurance creates confusion about which program pays first. If you have employer coverage, tell your HR department that you have Medicare and Medicaid so they can advise you.

What happens to my Medicaid if I move to a different state?

Medicaid does not transfer between states. If you move, your coverage ends in your old state and you must explore in your new state. The new state has different income and asset limits, so you may or may not may have access to. explore as soon as you move so there is no gap in coverage. Contact your new state's Medicaid office before or right after you arrive.