Many people assume they must choose between Medicare and Medicaid. However, it is possible to qualify for both programs at the same time.

When someone has both Medicare and Medicaid, they are often called a dual eligible beneficiary. Depending on their eligibility and the type of Medicaid assistance they receive, they may qualify for help with Medicare premiums, deductibles, copayments, and certain healthcare services.

Understanding how these programs work together can help you identify benefits you may be eligible to receive.

🩺 What Is the Difference Between Medicare and Medicaid?

Although their names sound similar, Medicare and Medicaid serve different purposes.

Medicare is a federal health insurance program primarily for people age 65 and older, as well as certain younger people with disabilities or specific medical conditions.

Medicaid is a joint federal and state program that provides healthcare coverage to eligible people based on income and other state-specific requirements.

Medicare eligibility is not generally based on income alone. Medicaid eligibility, on the other hand, depends on financial and other requirements that vary by state and eligibility category.

💰 What If You Qualify for Both Programs?

If you qualify for both Medicare and Medicaid, Medicare generally pays first for services covered by both programs. Medicaid may then help pay certain remaining costs, depending on your eligibility and state rules.

Some people qualify for a Medicare Savings Program, which can help pay Medicare premiums and, in some cases, other Medicare cost-sharing expenses.

People with limited income and resources may also qualify for Extra Help, a program that helps with eligible Medicare Part D prescription drug costs.

The amount of assistance available depends on the program and your eligibility.

📋 How Can You Find Out If You Qualify?

If you already have Medicare and are concerned about healthcare costs, it may be worth checking whether you qualify for additional assistance.

You can start by contacting your state Medicaid agency or your State Health Insurance Assistance Program (SHIP). SHIP provides free, personalized Medicare counseling.

You may need to provide information about your income, resources, household circumstances, and current coverage.

Do not assume you earn too much to qualify without checking the applicable rules. Different assistance programs have different eligibility requirements.

🎯 Bottom Line

Medicare and Medicaid can work together to help eligible individuals manage healthcare expenses. If you have limited income or resources, checking your eligibility for Medicaid, a Medicare Savings Program, or Extra Help may uncover support you did not know was available.

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