Medicaid & Medicare
If you have both Medicaid and Medicare, you're "dual eligible" — and you have special options.
The Short Version
- You can have both Medicaid and Medicare at the same time.
- Medicaid may pay your Medicare premiums and other costs.
- Dual Special Needs Plans (D-SNPs) are designed specifically for people like you.
What "Dual Eligible" Means
If you qualify for both Medicare (usually because of age or disability) and Medicaid (because of limited income), you're considered "dual eligible."
About 12 million Americans are dual eligible.
How They Work Together
- Medicare pays first for services both programs cover
- Medicaid pays second for remaining costs
- Medicaid may cover things Medicare doesn't — like long-term care, dental, vision
Dual Special Needs Plans (D-SNPs)
These are Medicare Advantage plans designed specifically for dual-eligible people:
- Coordinate your Medicare and Medicaid benefits
- Often have $0 premiums
- May include extra benefits (dental, vision, hearing, transportation)
- One card, one plan to manage
Medicare Savings Programs
Even if you don't have full Medicaid, you may qualify for help paying Medicare costs:
- QMB: Pays your Part B premium, deductibles, and coinsurance
- SLMB: Pays your Part B premium
- QI: Pays your Part B premium (slightly higher income limit)
Contact your state Medicaid office to see if you qualify.
Extra Help (Low Income Subsidy)
If you have limited income, you may also qualify for Extra Help with Part D prescription drug costs:
- Reduces or eliminates Part D premiums
- Lowers deductibles and copays for medications
- Apply through Social Security or your state Medicaid office
Action Steps
- Keep both your Medicare and Medicaid coverage
- Ask about D-SNP plans in your area
- Check if you qualify for Medicare Savings Programs
- Apply for Extra Help with drug costs