Can Seniors Qualify For Medicare And Medicaid At The Same Time?

Many older Americans have both Medicare and Medicaid at the same time. When someone can claim both, they're known as dual-eligible beneficiaries. To qualify, you need to meet your state's Medicaid rules for income and savings, on top of already qualifying for, and receiving, Medicare. According to Medicaid, 12 million people are dually enrolled, or more than 15% of all Medicaid beneficiaries.

When you have both Medicare and Medicaid, the former pays for your medical services first, while Medicaid can cover what's left – such as premiums, deductibles, and other costs that Medicare might not fully pay. Medicaid can also pay for things that Medicare does not cover, such as long-term care services. You'll also find health plans made for dual-eligible beneficiaries, called Dual Eligible Special Needs Plans, or D-SNPs. A D-SNP is a Medicare Advantage plan that works together with your state's Medicaid to help manage care and cover prescription drug costs through Part D.

Each D-SNP is available only in certain counties and works with certain doctors and hospitals, so the options and extras can be different depending on where you live. If a D-SNP is not a good fit, you can still use Original Medicare, or another Medicare Advantage plan. As you compare plans, remember that Medicare's out-of-pocket spending cap in 2025 limits what you will have to pay for covered Part D prescriptions each year.

If you do not qualify for full Medicaid, you might still be able to get financial help through a Medicare Savings Program (MSP), which can cover certain costs for people with lower incomes. As of September 2025, there are four main MSPs, each with its own income and asset limits. The Qualified Medicare Beneficiary (QMB) program pays both Part A and Part B premiums as well as deductibles, coinsurance, and copays. For QMB, your monthly income must be no more than $1,325 if you are single or $1,783 for a married couple. Plus, your assets can't be above $9,660 for a single person or $14,470 for a couple. The Specified Low-Income Medicare Beneficiary (SLMB) program only pays your Part B premium and has an income limit of $1,585 per month, and $9,660 in asset resources, for a single person, or $2,135 and $14,470 for couples.

The Qualifying Individual (QI) program also pays the Part B premium, with income limits of $1,781 per month, and $9,660 in resources for singles, or $2,400 and $14,470 for couples. Finally, the Qualified Disabled and Working Individuals (QDWI) program pays Part A premiums for those with disabilities who are still working, and has higher income limits for qualification — $5,302 a month, and $4,000 in asset resources, for singles, or $7,135 and $6,000 in asset resources for couples. Some states set higher thresholds and count different assets, so make sure to check your state's Medicaid or MSP page before applying to confirm what plans are available to you. However, keep in mind that as Medicare cuts continue in 2025, program availability could shrink.