Who is eligible for both Medicare and Medicaid depends on your age, your income, your savings, and the rules in your state.
If you already have Medicare and your budget is tight, Medicaid or a state savings program may pay some of your Medicare costs. This guide explains who qualifies, how the two programs work together, and what the combination means for your Medicare supplement or Medicare Advantage choices.
By the end, you will know which questions to ask, where to apply, and how to compare your plan options with confidence.
What Does It Mean to Be Eligible for Both Medicare and Medicaid?
People who are eligible for both Medicare and Medicaid are called dual eligible.
Medicare is the federal health program for people age 65 or older and for some younger people with disabilities. Medicaid is a joint federal and state program, and your state sets its own income and savings limits. When you qualify for both, Medicare pays first for approved care, and Medicaid may help with costs Medicare leaves behind.
Being eligible for both Medicare and Medicaid can lower what you pay for premiums, deductibles, and copayments.
Full-Benefit and Partial-Benefit: Who Is Dual Eligible for Medicare and Medicaid?
Federal rules sort people who are dual eligible for Medicare and Medicaid into two groups, and the group you land in decides how much help you get.
According to the Centers for Medicare & Medicaid Services (CMS), full-benefit dual eligible people qualify for full Medicaid in addition to Medicare. Partial-benefit dual eligible people receive help with Medicare costs only.
- Full-benefit: You get Medicaid benefits and help with Medicare costs. These groups are called QMB Plus, SLMB Plus, and Other Full Benefit.
- Partial-benefit: You get help with Medicare costs but not full Medicaid. These groups are called QMB Only, SLMB Only, QI, and QDWI.
The difference matters because it shapes which plan options make sense for you.
The Medicare Savings Programs and Their 2026 Limits
Three Medicare Savings Programs help pay Medicare costs, and each one has its own income limit.
Medicare.gov lists these 2026 federal limits, which are monthly income amounts for one person and for a married couple:
- QMB (Qualified Medicare Beneficiary): Up to $1,350 for an individual or $1,824 for a couple. It pays your Part B premium, deductibles, coinsurance, and copayments.
- SLMB (Specified Low-Income Medicare Beneficiary): Up to $1,616 for an individual or $2,184 for a couple. It pays your Part B premium.
- QI (Qualifying Individual): Up to $1,816 for an individual or $2,455 for a couple. It also pays your Part B premium.
All three programs use the same resource limits: $9,950 for an individual and $14,910 for a couple. States can be more generous, and the limits run higher in Alaska and Hawaii.
Check your state’s rules, because you may qualify even if your numbers sit above the federal limits.
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How Medicare and Medicaid Work Together
When you are eligible for both Medicare and Medicaid, the two programs pay in a set order.
Medicare is the primary payer, so it pays first for services it approves. Medicaid then acts as the payer of last resort and may pay your Medicare costs, depending on your category. The 2026 numbers show why this helps: the standard Part B premium is $202.90 a month, the Part B deductible is $283 a year, and the Part A deductible is $1,736 for each benefit period, according to Medicare.gov.
If you are in the QMB group, federal law also protects you from being billed. CMS states that providers may not bill QMB enrollees for Medicare deductibles, coinsurance, or copayments.
That protection is one of the most useful features of dual eligibility.
Extra Help With Prescription Drug Costs
People in the Medicare Savings Programs also get Extra Help with Part D prescription drug costs.
Medicare.gov says QMB, SLMB, and QI enrollees receive Extra Help, which lowers what you pay at the pharmacy. You do not need a separate application to qualify through one of these programs.
Ask your pharmacist or plan how Extra Help appears on your drug costs.
Your Plan Choices: Medicare Supplement or Medicare Advantage
Dual eligibility does not remove your plan choices, and it can change which choice makes sense.
You generally pick one of two paths for your Medicare benefits. The first is Original Medicare with a Medicare supplement plan. The second is a Medicare Advantage plan, including one of the dual eligible special needs plans (D-SNP) designed for people who have both Medicare and Medicaid.
- Medicare supplement: This plan pays costs that Original Medicare leaves behind. If Medicaid already pays those costs for you, a supplement may add little, so compare what you would pay with what you would gain.
- D-SNP: This Medicare Advantage plan coordinates your Medicare and Medicaid benefits, and some D-SNPs add extras such as dental, vision, and hearing. Plan rules vary by state, so ask what applies where you live.
You cannot use a Medicare supplement with a Medicare Advantage plan, so the choice is either-or.
Who Decides If You Are Eligible for Both Medicare and Medicaid?
Two different agencies decide, and each one has its own application.
Social Security and the federal Medicare program decide Medicare eligibility. Your state Medicaid agency decides Medicaid and Medicare Savings Program eligibility. Medicare.gov explains that these programs are run by your state, so you apply through your state.
MediGap Advisors helps with Medicare supplement and Medicare Advantage plans, while your state Medicaid office handles Medicaid itself.
How to Apply for Help
You can apply before you are sure you qualify, because the state makes the final decision.
Medicare.gov advises you to apply even if you do not think you qualify. Start with your state Medicaid agency or your county social services office. You can submit your application first and gather the proof of income and savings that the state requests afterward.
Free help is available too. A State Health Insurance Assistance Program (SHIP) counselor can walk you through the forms at no cost through SHIP.
Applying early gives you a clear answer before you choose a plan.
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Frequently Asked Questions
1. Who is eligible for both Medicare and Medicaid?
You must qualify for Medicare first, then meet your state’s Medicaid or Medicare Savings Program rules.
Medicare generally starts at age 65 or with a qualifying disability. Medicaid depends on your income and savings, and each state sets its own limits.
2. Can I have a Medicare supplement and Medicaid at the same time?
Yes, you can, but it may not add much.
Medicaid may already pay the costs a supplement would pay, so the extra monthly premium may not earn its keep. Compare your out-of-pocket costs with and without the supplement before you decide.
3. Does qualifying for a Medicare Savings Program mean I have full Medicaid?
Not always.
Some programs, such as QI, help only with Medicare costs. Full Medicaid is a separate decision made by your state, so ask the agency in writing which benefits you were approved for. That answer decides what you still need to buy.
4. Will Medicaid pay my Part B premium?
If you qualify for QMB, SLMB, or QI, your state pays it.
The standard Part B premium is $202.90 a month in 2026. Your state agency can tell you which program applies to you and when the savings begin. Ask for the decision letter.
5. Where do I apply?
Apply through your state Medicaid agency or your county social services office.
A SHIP counselor can help with the forms at no cost. You can also call 1-800-MEDICARE with questions about your Medicare benefits, and keep a copy of everything you submit.
Tom Lockwood is a Personal Benefits Manager at MediGap Advisors. Tom has a passion for bringing clarity to those who are confused about Medicare. He is an authority on Medicare, Medicare supplement plans, Medicare Advantage plans, and Part D prescription drug plans. Read more about Tom on his Bio page.