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AARP Medicare Question and Answer Tool
WILL I LOSE MEDICAID WHEN I BECOME ELIGIBLE FOR MEDICARE?
--------------------------------------------------------------------------------
By
AARP
Comments
En español
Published June 28, 2017
/ Updated November 17, 2022
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No, you won’t lose Medicaid coverage just because you qualify for Medicare.
As long as you continue to meet the eligibility requirements for Medicaid in
your state, you’ll receive both types of coverage even after you enroll in
Medicare. Both Medicare and Medicaid cover more than 11.2 million people, which
is known as being “dual eligible.”
Medicare is a federal program that covers medical expenses for more than 64.5
million Americans 65 and older — and younger people who qualify because of a
disability. Medicaid, which federal and state governments run jointly, provides
health care and long-term care coverage for more than 83.5 million people,
including children, parents, low-income adults, older adults and people with
disabilities.
While the federal government sets standards for Medicaid, individual states
determine your eligibility, generally based on your income and financial assets.
Coverage details vary by state so consider contacting your state Medicaid
office or your State Health Insurance Assistance Program (SHIP) to learn more
about the requirements and what’s covered.
HOW DOES MEDICARE WORK WITH MEDICAID?
If you’re eligible for both Medicare and Medicaid, Medicare settles your medical
bills first by paying its share of the cost of covered expenses. Medicaid
becomes secondary and pays costs after Medicare’s covered share, which includes
most of Medicare’s deductibles, copayments and other out-of-pocket costs.
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Medicaid can pay for Medicare premiums and some items that Medicare doesn’t
cover, such as long-term care in a nursing home. In some states, Medicaid also
covers dental care, glasses, long-term care in your home, transportation to and
from doctor’s visits, and other items Medicare doesn’t.
Those eligible for both Medicare and Medicaid can get their Medicare coverage
from original Medicare or a private Medicare Advantage plan. Some Advantage
plans are created specifically for dual eligibles and help coordinate the two
types of coverage. Some of these plans provide members with a care coordinator
who helps them navigate their benefits.
HOW DOES MEDICARE PART D COVERAGE WORK WITH MEDICAID?
If you have Medicaid and then become eligible for Medicare, you’ll have to find
new prescription coverage through Medicare’s Part D drug program. Then you’ll
automatically qualify for the federal Extra Help program, which enables you to
receive Part D drug coverage without paying premiums or deductibles. You’ll also
have low copays for your drugs.
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But to get this coverage, you need to enroll in a Part D drug plan. If you don’t
do this yourself, the Centers for Medicare & Medicaid Services (CMS) will select
one for you.
Part D costs, coverage and preferred pharmacies vary by plan, so it’s a good
idea to shop around and choose a plan that works best for you and your
circumstances. You can compare coverage for your medications and pharmacies
under the plans in your area with the Medicare Plan Finder or you can work with
your SHIP to get help choosing the best Part D plan for your needs.
Health & Wellness
AARP® Dental Insurance Plan administered by Delta Dental Insurance Company
Dental insurance plans for members and their families
View Details
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KEEP IN MIND
You may no longer qualify. If you had Medicaid coverage before you turned 65,
you may no longer be eligible after you turn 65. Some Medicaid programs don’t
continue coverage past 65, but the rules vary a lot by program and state. Find
out about the requirements from your state Medicaid office.
You can still get help. Even if you don’t qualify for Medicaid, a Medicare
Savings Program can still assist you with Medicare expenses. These programs help
participants pay Medicare Part A and Part B premiums, deductibles and
copayments, depending on the program you qualify for. Eligibility is based
on income and assets, which vary by state.
And possibly extra help. You may also qualify for help with Part D premiums and
copayments from the Extra Help program, which has higher income limits than
Medicaid and is expanding to even higher income levels in 2024.
Return to Medicare Q&A main page
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More on Medicare
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it costs
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The annual Part B deductible that beneficiaries must meet is also decreasing
next year
Experts Urge Earlier Planning for Long-Term Care
7 in 10 Americans will eventually need care; most underestimate the costs
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10% off dine-in or curbside carryout orders placed by phone
Learn More
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MEMBERS ONLY
Home & Real Estate
ADT™ Home Security
Savings on monthly home security monitoring
Learn More
See more Home & Real Estate offers >
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Health & Wellness
AARP® Staying Sharp®
Activities, recipes, challenges and more with full access to AARP Staying Sharp®
Learn More
See more Health & Wellness offers >
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234
*
*
*
*
* MEMBERS ONLY
Restaurants
Carrabba's Italian Grill®
10% off dine-in or curbside carryout orders placed by phone
Learn More
See more Restaurants offers >
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* MEMBERS ONLY
Home & Real Estate
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