Medicare question

Can you have both Medicare and Medicaid, and how does dual eligibility work?

If you are new to Medicare and also qualify for Medicaid, you may be able to use both programs. The coordination can be confusing. Start by understanding what dual eligibility means, how each application works, and which costs or services Medicaid may help with under your state's rules.

Last updated: August 17, 2026

What Is Dual Eligibility?

Dual eligibility means that a person qualifies for both Medicare and Medicaid. These two programs work together to provide comprehensive health coverage. Medicare is a federal program designed primarily for people aged 65 and older or those with certain disabilities. On the other hand, Medicaid is a joint state-federal program that helps low-income individuals and families.

Dual eligibility may help because Medicare and Medicaid can cover different costs or services. Medicare generally covers hospital care, doctor visits, and prescription drugs. Depending on state rules, Medicaid may help with Medicare cost sharing and services Medicare does not fully cover, such as certain long-term services and supports.

How Do You Qualify for Medicare and Medicaid Dual Eligibility?

To have dual coverage, you must meet the eligibility requirements for both Medicare and Medicaid. Here is how each program works:

What Medicare Requirements Apply to Dual Eligibility?

You can qualify for Medicare if:

You are 65 years old and a U.S. citizen or permanent resident.

You have been receiving Social Security Disability Insurance (SSDI) benefits for at least two years.

Medicare covers several categories of medical services, including hospital stays (Part A), doctor visits (Part B), prescription drugs (Part D), and some preventive care.

What Medicaid Requirements Apply to Dual Eligibility?

To qualify for Medicaid, you must meet your state's eligibility rules. Those rules can consider household size, monthly income, resources, age, disability, and other circumstances. In general:

You must have a limited income.

You may need to be disabled or over 65 years old.

Medicaid covers a wide range of services, including hospital visits, doctor visits, prescription drugs, vision care, dental care, and long-term care services.

How Do You Apply for Medicare and Medicaid Dual Eligibility?

Medicare and Medicaid require separate applications. Apply for Medicare through Social Security and Medicaid through your state Medicaid agency. Here is how to proceed:

How Do You Apply for Medicare as Part of Dual Eligibility?

You can apply for Medicare online at [the official website], by phone at 1-800-MEDICARE (1-800-633-4227), or in person at a Social Security office. When you apply, make sure to provide all necessary documentation such as your Social Security number and proof of citizenship.

How Do You Apply for Medicaid as Part of Dual Eligibility?

To apply for Medicaid, use your state Medicaid agency's website or contact the agency directly. Complete the application and provide any documents required to verify income, resources, residency, or other eligibility details.

How Are Medicare and Medicaid Benefits Coordinated for People with Dual Eligibility?

Once you are enrolled in both programs, they will coordinate benefits to ensure comprehensive coverage without gaps. Medicaid may cover Medicare premiums, deductibles, copayments, and services not covered by Medicare, such as dental care or vision exams.

What Services Are Covered Under Dual Eligibility?

Having dual eligibility can provide extensive health coverage because each program has its own set of benefits. Here are some key services that might be covered under both programs:

How Can Dual Eligibility Affect Coverage for Hospital Stays?

Medicare Part A covers inpatient hospital stays and skilled nursing facility care. Medicaid may also cover long-term care services, such as nursing home stays.

How Can Dual Eligibility Affect Coverage for Doctor Visits and Outpatient Care?

Medicare Part B covers doctor visits, outpatient treatments, preventive screenings, and lab tests. Medicaid can supplement these benefits by covering additional services like dental or vision exams not covered under Medicare.

How Can Dual Eligibility Affect Prescription Drug Coverage?

Both programs may cover prescription drugs, though the specific medications and coverage levels differ. Medicare has its own prescription drug program (Part D), while Medicaid also provides extensive drug coverage, sometimes even including those not available through Medicare Part D.

How Can Dual Eligibility Affect Preventive Care Coverage?

Medicare covers a range of preventive services such as annual wellness visits, flu shots, mammograms, and colonoscopies. Medicaid may cover additional preventive care services like dental cleanings or vision exams.

How Do Medicare and Medicaid Work Together for People with Dual Eligibility?

If you qualify for both programs, Medicare generally pays first and Medicaid may help with remaining costs or additional services under your state's rules. You apply to the appropriate agencies separately, then make sure your benefits are coordinated so you understand what each program pays.

Where should you look next?

What else do people ask about dual Eligibility?

• How can Extra Help, Medicare Savings Programs, and dual eligibility reduce Medicare costs?
• How do you apply for Extra Help and a Medicare Savings Program?
• Can I still qualify for Medicare cost assistance if I think my income is too high?
• What is a D-SNP for people eligible for both Medicare and Medicaid?
• How do Medicare Savings Programs work, what do they pay, and how can I apply?
• How does Extra Help work, and what income and asset limits determine eligibility?

All Medicare questions