How to Enroll in Medicaid and Have Medicare Coverage, Too
Key Takeaways
- When you qualify for MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). and MedicaidMedicaid is a state-based health insurance program for individuals that qualify. Unlike Medicare, Medicaid does not have age restrictions for members. , you are dual eligible. Dual eligibility allows beneficiaries to combine Medicare and Medicaid benefits to expand coverage and assist with costs. It is not a separate plan.
- Medicaid usually pays all qualified medical service costs for low-income individuals and families. For dual-eligible beneficiaries, Medicare always pays first. Medicaid may cover expenses not covered by Medicare.
- You do not have medical expenses because Medicare and Medicaid send payments to your providers.
Whether you’re new to Medicaid or one of 70 million people in a program, we have answers. Let’s begin with the basics: what is the difference between Medicaid and Medicare, and who can enroll in both?
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What’s the Difference Between Medicaid and Medicare?
Medicaid is a program that assists with health insurance costs. The program serves people that qualify based on a low income. Medicaid recipients usually do not pay the costs of covered medical services. When it is time to enroll, it is essential to know that Medicaid is a federal-state program. This means your state runs the program but must follow federal guidelines.
Medicare is a public health insurance program. Most people that use Medicare are 65 years of age or older. Beneficiaries pay part of their medical costs through premiums, deductibles, and co-insurance. Medicare is a federal program, and care plans are usually standardized everywhere in the United States.
Am I Dual-Eligible?
Dual-eligible beneficiaries can enroll in Medicare Part AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. , Medicare Part BMedicare Part B is medical insurance that covers Medicare-approved services — such as medically necessary treatment and preventive services — and certain other costs, like durable medical equipment. Medicare Part B is part of Original Medicare. , or both. They also can enroll in full Medicaid benefits or their state’s Medicare Savings Programs. If enrolled in both, your Medicare benefits always pay first, and Medicaid benefits assist with costs not fully covered by Medicare.
To qualify for both, you must meet federal requirements for Medicare, and then meet state-specific requirements for the Medicaid program.
After you’ve enrolled in both Original Medicare and Medicaid, you may have the option to switch to a Dual Eligible Special Needs Plan (D-SNP).
A D-SNP is a type of Medicare Advantage (Part C) plan offered by private insurance carrier. These plans must provide at minimum the coverage you would get under Original Medicare, plus Part D prescription drug coverage. D-SNPs may also offer a variety of additional benefits.
Contact an insurance carrier or a licensed insurance agent for more information about the D-SNPs available in your area.
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When Do I Enroll?
If you meet your state’s eligibility requirements, you can complete Medicaid applications at any time in person, by phone or online.
Most people become eligible for Medicare during their Initial Enrollment Period, which lasts for seven months around the time you turn 65. You may be able to enroll sooner if you have certain disabilities.
You can make changes to your Medicare coverage during the Annual Enrollment Period (AEP) between October 15 and December 7.
As of 2025, people who are dual eligible and qualify for full Medicaid benefits from their state can use a monthly Special Enrollment Period to join certain D-SNPs.
How Does Payment Work?
Medicaid does not pay money to you if you qualify. Medicaid sends payments to your health care provider after you receive services. Depending on your state’s program, you may be responsible for paying a small copayment (part of the cost) for some medical services.
How Do I Enroll?
The first thing you need to do is find out if you are eligibleSome health plans require you to meet minimum requirements before you can enroll. . You must be a resident of the state where you apply for the Medicaid program. Visit your state Medicaid site for information on eligibility, coverage and more. You can apply with your state Medicaid agency in person, over the phone or online.
Find the Medicare Plan that works for you.
Does Medicaid cover mental health, dental, nursing homes, or long-term care?
Who can tell me if I am eligible for Medicaid?
How are Medicare and Medicaid different for nursing home coverage?
Sources
- April 2020 Medicaid & CHIP Enrollment Data Highlights. Medicaid.gov.
- Contact Your State With Questions. Medicaid.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.