People with Medicare and Medicaid may have full Medicaid benefits or more limited help with Medicare costs. The category of assistance determines which benefits and billing protections apply.
You can have both Medicare and Medicaid. Medicare is federal health insurance. Medicaid is run jointly by the federal government and the states, so who qualifies and what it covers vary by state.
Some people have full Medicaid benefits. Others receive only help with Medicare costs through a Medicare Savings Program. Check the program named on your approval notice to find out which benefits and billing protections you have. Help with premiums alone does not give you every Medicaid service.
Who Pays First?
For Medicare-covered care:
- Medicare generally pays first.
- Other insurance pays according to coordination rules.
- Medicaid pays last.
Depending on the type of Medicaid coverage, it may help pay Medicare premiums, deductibles, coinsurance, and copayments. It may also cover services Medicare does not, such as certain long-term supports, transportation, dental care, or personal care.
How Does Drug Coverage Work?
People with both programs, called dual eligible, receive most prescription coverage through Medicare Part D, not Medicaid. People with full Medicaid automatically qualify for Extra Help, which lowers Part D costs.
If you do not select a drug plan, Medicare may enroll you in one to prevent a coverage gap. Review the plan to ensure it covers your prescriptions and pharmacies.
What Is a Dual Eligible Special Needs Plan?
A D-SNP is a Medicare Advantage Special Needs Plan designed for people with Medicare and Medicaid. These plans can coordinate benefits and may add services, but provider networks, requirements for approval before care, and available plans vary.
You can still choose Original Medicare instead of a D-SNP.
Protect Yourself From Improper Billing
If you are in the Qualified Medicare Beneficiary (QMB) program, Medicare providers generally cannot bill you for deductibles, coinsurance, or copayments for care covered by Medicare Part A or Part B. Show both cards. If a provider bills you for these protected costs, show its billing office proof of QMB status and ask it to correct the bill. If the bill continues, contact 1-800-MEDICARE or SHIP for help; the provider generally cannot charge you these protected amounts just because Medicaid has not paid it.
See Medicare's Medicaid coordination page.
If Medicaid or Extra Help Ends
If Medicaid or Extra Help is ending, keep the notice and follow its instructions for renewal, reapplying, or appeal. Separately ask Medicare which health or drug-plan change is permitted and by when. The loss-of-coverage rules depend on the benefit lost; do not assume every dual-eligible person has the same switching choices.
Medicare policy sources last checked: October 8, 2026.