Can I Have Medicare and Medicaid at the Same Time?

Yes. You can have Medicare and Medicaid at the same time, and millions of people do. People who have both are called “dual eligible.” Medicare stays your main health coverage, and Medicaid fills in behind it, often paying your premiums and some or all of what Medicare leaves you to pay.

The catch is that “having Medicaid” doesn’t mean the same thing for everyone. There are different levels of help, and which one you qualify for decides what gets paid.

Two programs, two different jobs

Medicare is a federal health insurance program, mostly for people 65 and older and people with certain disabilities. You qualify based on age or disability and your work history, not your income.

Medicaid is run by each state, under federal rules. You qualify based on your income and your savings, and the limits differ from state to state. Medicare.gov says that, generally, you must meet your state’s income and resource limits and other rules, such as living in the state.

Because one program is based on age and the other on income, plenty of people qualify for both.

Who pays first

Medicare.gov is plain about this: when you’re dual eligible and you get a Medicare-covered service, Medicare pays first. Medicaid pays last, after Medicare and any other health insurance you have.

In real life, your doctor or hospital bills Medicare first. Whatever Medicare doesn’t pay, such as a deductible or your share of the bill, then goes to Medicaid, depending on your level of coverage.

Full Medicaid vs. “partial” help

This is the part most people get wrong. There are two broad groups of dual eligibles.

Full-benefit dual eligibles qualify for their state’s complete Medicaid benefits. According to Medicare.gov, if you have full Medicaid:

• Your state pays your Medicare Part B premium.
• Depending on your Medicaid level, your state may also pay your Medicare deductibles, coinsurance, and copayments, plus your Part A premium if you owe one.
• You automatically get Extra Help with prescription drug costs.
• Medicaid may cover things Medicare doesn’t, such as nursing home care and personal care services.

Partial-benefit dual eligibles don’t get full Medicaid. CMS describes them as people enrolled in Medicare and a Medicare Savings Program only. A Medicare Savings Program is a state program that helps pay Medicare costs, but it doesn’t add Medicaid’s other benefits.

So someone who says “I’m on Medicaid” may have full coverage, or may only have help with their Part B premium. It’s worth knowing which one you have.

The Medicare Savings Programs

Medicare.gov lists four Medicare Savings Programs. You apply through your state, and Medicare.gov notes that some states use higher limits than the federal ones shown here (2026 federal limits for one person, from Medicare.gov).

Qualified Medicare Beneficiary (QMB). Pays your Part B premium, your Part A premium if you owe one, and your deductibles, coinsurance, and copayments for Medicare-covered care. The federal limits are $1,350 a month in income and $9,950 in resources for an individual (Medicare.gov, 2026).

Specified Low-Income Medicare Beneficiary (SLMB). Pays your Part B premium only. The federal limits are $1,616 a month in income and $9,950 in resources for an individual (Medicare.gov, 2026).

Qualifying Individual (QI). Also pays your Part B premium only. The federal limits are $1,816 a month in income and $9,950 in resources for an individual (Medicare.gov, 2026). You must reapply every year, and states approve QI first-come, first-served. QI is only for people who don’t qualify for other Medicaid coverage.

Qualified Disabled and Working Individuals (QDWI). Pays the Part A premium for certain people with disabilities who went back to work and lost premium-free Part A.

The Part B premium these programs cover is $202.90 a month in 2026 (Medicare.gov). If that premium normally comes out of your Social Security check, this help means it no longer does.

Medicare.gov also says each of the first three programs comes with Extra Help for prescription drugs, which caps what you pay for each covered drug at $12.65 in 2026 (Medicare.gov).

Your providers can’t bill you if you have QMB

If you have QMB, Medicare.gov says Medicare providers aren’t allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments. You may still owe a small Medicaid copayment in some cases.

Billing mistakes still happen. Medicare.gov suggests showing both your Medicare card and your Medicaid or QMB card every time you get care. If you have Original Medicare, your Medicare Summary Notice also shows your QMB status, so you can bring that too.

What about prescription drugs?

Even with full Medicaid, your prescriptions are covered through Medicare, not Medicaid. Medicare.gov says dual eligibles are automatically enrolled in a Medicare drug plan. If Medicare doesn’t cover a particular prescription, Medicaid may still cover it in some cases.

Your coverage choices

Having both programs doesn’t lock you into one kind of plan. Medicare.gov says you can choose Original Medicare or a Medicare Advantage plan. There are also options built for people with both, including Dual Eligible Special Needs Plans and PACE (Program of All-Inclusive Care for the Elderly), which can help certain people get care outside a nursing home. We cover how those plans work in our guide to Medicare Special Needs Plans.

Common mistakes

Assuming you earn too much. Limits vary by state, and some states use higher limits than the federal ones. Some states also let you “spend down,” meaning you can count medical bills against income that’s over the limit, according to Medicare.gov. CMS has also reported that more than half of people eligible for a Medicare Savings Program aren’t enrolled. If you’re close, apply and let the state decide.

Thinking you have to pick one program. You don’t. Medicare stays primary. Medicaid works behind it.

Worrying about Medicaid work requirements. Starting January 1, 2027 (earlier in some states), certain adults must meet a monthly work or activity requirement to keep Medicaid. Medicare.gov states that this requirement doesn’t apply to people with Medicare.

Letting coverage lapse at renewal. Medicaid and the Medicare Savings Programs have to be renewed, and QI must be reapplied for each year. Open and answer any mail from your state Medicaid office. A missed renewal can mean your Part B premium suddenly comes out of your check again.

How to apply

Apply through your state Medicaid office. Medicaid.gov lists every state’s program and how to contact it.

For free, unbiased help, you can contact your State Health Insurance Assistance Program (SHIP), or call 1-800-MEDICARE.

Sources: Medicare.gov, “Medicaid” (medicare.gov/basics/costs/help/medicaid); Medicare.gov, “Medicare Savings Programs” (medicare.gov/basics/costs/help/medicare-savings-programs); Medicare.gov, “Medicare costs” (medicare.gov/basics/costs/medicare-costs); CMS Medicare-Medicaid Coordination Office, “People Dually Eligible for Medicare and Medicaid” fact sheet (cms.gov/medicare-medicaid-coordination/medicare-and-medicaid-coordination/medicare-medicaid-coordination-office/downloads/mmco_factsheet.pdf).