Can You Have Medicare and Medicaid?

Medicare is health insurance for people 65 and older and some younger people with disabilities. Medicaid is help from your state for people with low income and savings. If you qualify for both, Medicare pays your bills first and Medicaid pays most of what's left. That matters when copays pile up, or when you need more help at home than family can give. You apply for Medicaid through your state.

You may qualify if

• You have Medicare.
• Your income is low, and each state sets its own limit. In 2026, it's $1,836 a month for one person in both California and New York, not counting the first $20 of income.
• Your savings are under your state's limit. A few states have no limit for the programs that pay Medicare costs.

Not sure you qualify? Apply anyway, because the state makes the call and some of your income may not count. If you would rather not do it alone, a Pair Team advocate can check with you in one call.

Full and partial dual eligible

The Medicare Savings Programs below are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI).

QMB Plus means you have QMB and full Medicaid, and SLMB Plus means SLMB and full Medicaid. If you only need help with Medicare costs, see Medicare Savings Programs.

What does Medicaid pay for that Medicare does not?

Medicaid mostly pays for long-term care and the costs Medicare leaves behind. Full Medicaid can pay for:

• Your copays and the rest of the bill after Medicare pays.
• Long nursing home stays.
• Rides to medical visits, which Medicaid.gov says every state must cover. See Rides to medical appointments.
• In many states, help at home with bathing and dressing, dental care and eyeglasses. Each state picks which of these it covers.

Do I get Extra Help with prescriptions?

Yes, you get Extra Help with prescriptions automatically if you have Medicare and full Medicaid, Medicare.gov says. Your drugs are covered by a Medicare drug plan, not by Medicaid. Since 2025, if you have Medicaid or Extra Help, you can switch drug plans once a month.

Are there plans just for people with both?

Yes, one kind is a Dual Eligible Special Needs Plan (D-SNP), a type of Medicare Advantage plan just for people with both. Some D-SNPs, called integrated plans, give you your Medicare and Medicaid in one plan with one care team. Others only help coordinate the two.

The Program of All-Inclusive Care for the Elderly (PACE) is another choice in some areas. It's for people 55 and older who need nursing home level care but still live at home.

Since 2025, if you have full Medicaid, you can join or switch to an integrated plan once a month. Each plan has its own doctors, so compare before you switch. A counselor from your State Health Insurance Assistance Program (SHIP) can help you compare.

How to apply

1. Find your state's Medicaid office. Your SHIP can tell you where it is. For California, New York and Nevada, see the state pages below.
2. Get your papers together. The state will want your Medicare card, proof of income like your Social Security letter, and bank statements.
3. Ask to be checked for everything. Ask for full Medicaid and for a Medicare Savings Program. If you don't qualify for one, you may still get the other.
4. Wait for the answer. Federal rules give the state up to 45 days to decide, or 90 if it has to decide about a disability.
5. Get free help if you want it. Your SHIP gives free one-on-one help. Call 1-877-839-2675 or visit shiphelp.org.

What a Pair Team advocate does

When someone calls us about Medicaid, the application is rarely the only problem. Often there's a home care question, or a bill that should have gone to Medicaid. This is what we do:

• Figure out if you can likely get full Medicaid, a Medicare Savings Program, or both, in one phone call.
• Help you gather your papers, apply, and follow up with the state until you have an answer.
• Help you fix bills that should have gone to Medicaid, and set up rides to your visits.
• Help with what usually comes with it: help at home, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Who pays first, Medicare or Medicaid?

Medicare pays first, and Medicaid pays last, after Medicare and any other insurance you have. If you have QMB, doctors can't bill you for Medicare copays.

Does the new Medicaid work rule apply to me?

The new Medicaid work rule does not apply to you if you have Medicare, Medicare.gov says. Starting January 1, 2027, some adults on Medicaid must work or do other approved activities 80 hours a month.

Will Medicaid take my house after I die?

Medicaid has to wait while a spouse, a child under 21, or a blind or disabled child is still living. After that, your state can try to get back what it spent on your care after age 55, mostly long-term care. It also cannot take back what a Medicare Savings Program paid. If you're worried about your home, ask your state Medicaid office how its rules work.

What if my income is a little too high?

If your income is a little too high, you may still get help. Some states let you count medical bills against your income each month, which is called a spenddown. A Medicare Savings Program may also fit, since its limits are often higher. Ask your state Medicaid office about both.

Do I have to join a special plan?

You don't have to join a special plan for Medicare, because you can keep Original Medicare and use Medicaid with it. Some states do ask you to get your Medicaid through a health plan.

Find the rules for your state

• California: Medicaid for people 65 and older, the $130,000 savings limit that came back in 2026, and Medi-Medi Plans.
• New York: the 2026 income and savings limits, the spenddown program, and New York's combined plans.
• Nevada: full Medicaid at home is mostly for people with income under about $1,030 a month in 2026, with no spenddown.

Everywhere else, call your state Medicaid office, or your SHIP at 1-877-839-2675 for free help.

Sources

• Medicaid, Medicare.gov
• Special Enrollment Periods, Medicare.gov
• CMS Guidance: Reporting Expectations for Dual-Eligible Beneficiaries, Medicaid.gov
• Mandatory and Optional Medicaid Benefits, Medicaid.gov
• Estate Recovery, Medicaid.gov
• 42 CFR 435.912, Timely determination of eligibility, eCFR
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• Important Changes in 2025 to Special Enrollment Periods for Low-Income Medicare Enrollees, Justice in Aging
• State Health Insurance Assistance Programs