All states offer a variety of Medicaid programs, several of which can help people with Medicare. If you qualify for a Medicaid program, it may help pay for costs and services that Medicare does not cover.
- For services covered by both Medicare and Medicaid (such as doctors’ visits, hospital care, home care, and skilled nursing facility care), Medicare is the primary payer. Medicaid is the payer of last resort, meaning it always pays last. When you visit a provider or facility that takes both forms of insurance, Medicare will pay first and Medicaid may cover your Medicare cost-sharing, including coinsurances and copayments.
- In many cases, if you have Medicare and Medicaid, you will automatically be enrolled in a Medicare Savings Program (MSP). MSPs pay your Medicare Part B premium, and may offer additional assistance.
- Depending on your income, you may qualify for the Qualified Medicare Beneficiary (QMB) MSP. If you are enrolled in QMB, you do not pay Medicare cost-sharing, including deductibles, coinsurances, and copays.
- Dually eligible individuals are automatically enrolled in the Extra Help program to help with their prescription drug costs.
- Some states require certain Medicaid beneficiaries to enroll in Medicaid private health plans, also known as Medicaid Managed Care (MMC) plans. These plans may offer optional enrollment in a Medicare Advantage Plan designed to better coordinate your Medicare and Medicaid benefits. Note: You cannot be required to enroll in a Medicare Advantage Plan.