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 million people, which is known as being “dual eligible.”
How does Medicaid work with Medicare? #
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.
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 people who are dual eligible 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 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.
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.