Which Medicaid programs might I qualify for if I have Medicare?

Section IX.c. Medicaid and Medicare
Question 3 of 11 (use "Last" or "Next" buttons to see more)

If you are eligible for Medicare and have low income, you may qualify for help from certain Medicaid programs in your state. In general, your state will have more than one program that can help people who are eligible for Medicare.

Whether you qualify for a Medicaid program will depend on:

 

  • your income (money you take in, for example, from Social Security payments or wages that you earn);
  •  

  • your assets (resources such as checking accounts, stocks and some property); and
  •  

  • if you need long-term care, whether you meet your state�s �functional eligibility� or �level-of-care� criteria�standards for assessing your need for help with activities of daily living (for example, toileting, bathing, dressing) and your need for nursing care. Each state sets its own standards.

Medicaid programs can help pay for Medicare�s costs and for services that Medicare does not cover.

 


In general, people with Medicare who have low income may qualify for one of the following:

 

     
  1. Medicaid for people who are �over 65, blind or have a disability� and do NOT need long-term care.

    If you are over 65, blind or have a disability, do not have a pressing need for long-term care and meet the financial requirements, you may qualify for Medicaid coverage of a broad range of health services, including doctors� visits, hospital care, and medical equipment.

     


  2.  

  3. Nursing Facility Medicaid

    If you have limited income and meet your state�s �level-of-care� or �functional eligibility� criteria, Nursing Facility Medicaid may pay for a stay in a skilled nursing facility (nursing home). Nursing Facility Medicaid covers services such as room and board, nursing care, personal care and therapy services, States determine their own �functional eligibility� standards, but usually your state will assess your need for help with activities of daily living (for example, toileting, bathing, dressing) and your need for nursing care. All states have Nursing Facility Medicaid programs.

     


  4.  

  5. Medicaid Waiver Programs for long-term care in your home or community

    If you have limited income and meet your state�s �level-of-care� or �functional eligibility� criteria, a Medicaid home and community-based service(HCBS) waiver program (or programs) may cover long-term care services in your home or a community setting (for example, in an assisted living facility). States determine their own �functional eligibility� standards, but usually your state will assess your need for help with activities of daily living (for example, toileting, bathing, dressing) and your need for nursing care.


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How does Medicaid work with Medicare to cover my health care costs?

Getting Medicaid if you do not need long-term care and have Medicare

Long term care

How can I get Medicaid if I need nursing home care and have Medicare?

How can I get Medicaid if I need long-term care in my home or my community and have Medicare?

 
LINKS
State Health Insurance Assistance Program (SHIP) Directory

State Medicaid Programs

 
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