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Medicaid

Medicaid is a joint federal and state program that:

  • Helps with medical costs for some people with limited income and resources
  • Offers benefits not normally covered by Medicare, like nursing home care and personal care services

How to apply for Medicaid

Each state has different rules about eligibility and applying for Medicaid. Call your state Medicaid program to see if you qualify and learn how to apply.

Medicaid spend down

Even if you have too much income to qualify, some states let you "spend down" to become eligible for Medicaid. The "spend down" process lets you subtract your medical expenses from your income to become eligible for Medicaid. In this case, you're eligible for Medicaid because you're considered "medically needy."

To be eligible as "medically needy," your measurable resources must also be under the resource amount allowed in your state. Call your state Medicaid program to see if you qualify and learn how to apply.

Dual eligibility

Some people who are eligible for both Medicare and Medicaid are called “dual eligibles.” If you have Medicare and full Medicaid coverage, most of your health care costs are likely covered.

You can get your Medicare coverage through Original Medicare or a Medicare Advantage Plan (Part C). If you have Medicare and full Medicaid, you'll get your Part D prescription drugs through Medicare. And, you'll automatically qualify for Extra Help paying for your Medicare prescription drug coverage (Part D). Medicaid may still cover some drugs and other care that Medicare doesn’t cover.

Who pays first—Medicaid or Medicare?

Medicaid never pays first for services covered by Medicare. It only pays after Medicare, employer group health plans, and/or Medicare Supplement (Medigap) Insurance have paid.