Medicaid and Medicare are two different government health insurance programs, and you can qualify for both at the same time. Medicare is primarily for people 65 and older, plus certain younger people with disabilities. Medicaid is a joint federal and state program for people with limited income and resources. Qualifying for each depends on your age, income, disability status, and in some cases, your state of residence.
What Is the Difference Between Medicare and Medicaid?
Medicare is a federal program. It works the same way in every state. Most people become eligible when they turn 65. Some younger people qualify through a disability or specific conditions like end-stage renal disease or ALS.
Medicaid is different. The federal government sets broad rules, but each state runs its own program. That means income limits, application processes, and covered services can vary significantly depending on where you live.
You can have both. People with both programs are called “dual eligible.” Medicare is the primary payer. Medicaid can help cover costs Medicare does not, like premiums, copays, and services Medicare does not cover such as long-term care.
How Do You Qualify For Medicaid And Medicare Based on Age?
Age is the clearest path to Medicare. You qualify for Medicare Part A (hospital insurance) at age 65 if you or your spouse worked and paid Medicare taxes for at least 10 years. Most people do not pay a premium for Part A.
Medicare Part B (medical insurance) requires a monthly premium. In 2024, the standard Part B premium is $174.70 per month. This amount can change each year.
If you are 65 but do not have enough work history, you may still qualify for Part A by paying a monthly premium. You can also qualify through a spouse’s work record, including a divorced spouse under certain conditions.
Medicaid has no age requirement for children or adults. However, states have specific Medicaid pathways for older adults, often called “aged, blind, and disabled” coverage. These programs typically have higher income limits than Medicaid for younger adults.
How Do You Qualify For Medicaid And Medicare Through Disability?
You can get Medicare before age 65 if you have received Social Security Disability Insurance (SSDI) for 24 months. The 24-month waiting period starts from the date you become eligible for SSDI benefits, not the date you applied.
People with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant) can qualify for Medicare without the 24-month wait. People with ALS (Lou Gehrig’s disease) also qualify immediately upon receiving SSDI.
Medicaid eligibility through disability works differently. Each state has its own definition of disability for Medicaid purposes. Many states use the same definition as the Social Security Administration, but not all do.
Some states offer Medicaid buy-in programs for working people with disabilities. These programs allow people with higher incomes to pay a premium for Medicaid coverage. Eligibility varies by state.
What Are the Income Limits for Medicaid?
Medicaid income limits depend on your state and your eligibility category. There is no single national number.
For adults under 65, the Affordable Care Act allowed states to expand Medicaid to adults with incomes up to 138% of the federal poverty level. As of 2024, 40 states and Washington, D.C. have adopted this expansion.
In states that expanded Medicaid, a single adult earning up to about $20,783 per year may qualify in 2024. This figure is based on the federal poverty level of $15,060 for a single person.
In states that did not expand Medicaid, income limits are much lower. In many of these states, childless adults cannot qualify for Medicaid at all regardless of income, unless they are pregnant, disabled, or caring for children.
For older adults and people with disabilities, income limits are often higher. Many states allow income up to 100% of the federal poverty level for these groups, which is $15,060 for a single person in 2024.
What Are the Asset Limits for Medicaid?
Medicaid is not just about income. Many eligibility categories also have asset limits. Assets include bank accounts, stocks, bonds, and property other than your primary home.
For older adults and people with disabilities, most states have an asset limit of $2,000 for a single person and $3,000 for a couple. Some states have higher limits or no asset test at all for certain groups.
Your primary home, one vehicle, and personal belongings are typically excluded from the asset calculation. Burial funds up to a certain amount are also excluded in most states.
Medicare does not have an asset test. Your savings, investments, and property do not affect Medicare eligibility. Only your work history or disability status matters.
If you have assets above your state’s Medicaid limit, you may need to spend down your assets before you qualify. This is a common concern for older adults who need long-term care. Some states allow “spend down” programs where you can qualify if your medical expenses reduce your countable income to the eligibility level.
How Do You Apply for Medicare and Medicaid?
You apply for Medicare through the Social Security Administration. You can apply online, by phone, or in person at a local Social Security office.
If you are already receiving Social Security benefits, you are automatically enrolled in Medicare Parts A and B when you turn 65. Your Medicare card arrives in the mail about three months before your 65th birthday.
If you are not receiving Social Security, you need to apply for Medicare yourself. The initial enrollment period begins three months before your 65th birthday and ends three months after the month you turn 65.
You apply for Medicaid through your state’s Medicaid agency. Each state has its own application process. Many states allow online applications, and most also accept applications by mail, phone, or in person.
You can apply for both programs at the same time in most states. The application will ask about your income, assets, household size, and any disabilities. The state agency determines whether you meet Medicaid eligibility rules.
What Is the Medicare Savings Program?
The Medicare Savings Program (MSP) helps people with limited income pay for Medicare costs. This is a state-run program that uses federal funds.
There are four levels of MSP. Each level covers different costs. The Qualified Medicare Beneficiary (QMB) program pays for Part A and Part B premiums, deductibles, and copays. The Specified Low-Income Medicare Beneficiary (SLMB) program pays only the Part B premium.
Income limits for MSP are higher than regular Medicaid limits. In 2024, the QMB program allows income up to $1,275 per month for a single person and $1,724 for a couple. Asset limits are $9,090 for a single person and $13,630 for a couple.
If you qualify for MSP, you automatically qualify for Extra Help, the federal program that helps pay for prescription drug costs under Medicare Part D.
Frequently Asked Questions
Can I have both Medicare and Medicaid at the same time?
Yes, you can have both. People with both are called “dual eligible.” Medicare pays first, and Medicaid covers most remaining costs like premiums and copays.
What is the income limit for Medicaid in 2024?
There is no single national limit. In states that expanded Medicaid, a single adult can earn up to 138% of the federal poverty level, which is about $20,783 per year in 2024.
Do I need to be 65 to get Medicare?
No. You can get Medicare before 65 if you have received Social Security Disability Insurance for 24 months, or if you have end-stage renal disease or ALS.
Does Medicare have an asset limit?
No. Medicare does not consider your savings or property. Only your work history or disability status matters for Medicare eligibility.
