Medicare and health costs

Medicaid for people with Medicare

Medicaid is health coverage for people with low income and savings, and you can have it on top of Medicare. It can pay your Medicare premiums and out-of-pocket costs, and cover things Medicare doesn't, like long nursing home stays. Your state runs it, so the name, the limits and how to apply depend on where you live.

Checked Oct 28, 2026

Rules set by the Centers for Medicare & Medicaid Services

An older woman in her kitchen reads a letter from the day's mail

Rules in your state

Your state runs Medicaid for people with Medicare, so the name, the limits and how to apply depend on where you live.

Who may qualify

Who may qualify for Medicaid for people with Medicare
	One person	Married couple
SSI income level most states start from (2026)	$994 a month	$1,491 a month Source: Centers for Medicare & Medicaid Services (source 4)
SSI savings limit	$2,000	$3,000 Source: Centers for Medicare & Medicaid Services (source 4)

How states decide for people 65 and older	Most use SSI's rules for counting income and savings. Some states, called 209(b) states, use stricter rules. Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)
If you get SSI	States must cover people who get SSI, and coverage may come without a separate income check Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)
If your income is too high	36 states and DC let you "spend down": medical bills you owe count against your income until you're under the state's limit Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)
Home equity limit for long-term care (2026)	$752,000 to $1,130,000, depending on your state Source: Centers for Medicare & Medicaid Services (source 4)
Citizenship and residence	U.S. citizen or certain qualified non-citizens, such as lawful permanent residents, living in the state Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)

What you may get

What Medicaid for people with Medicare pays
What Medicaid can add to Medicare	Nursing home care beyond Medicare's 100-day limit, prescription drugs, eyeglasses and hearing aids Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 1)
Help with Medicare costs	Medicaid can pay Medicare premiums and out-of-pocket medical costs Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 1)
Who pays first	Medicare pays first. Medicaid fills in the difference, up to your state's payment limit. Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 1)
Savings a spouse at home may keep when the other needs long-term care (2026)	Between $32,532 and $162,660, depending on your state Source: Centers for Medicare & Medicaid Services (source 4)
Monthly income a spouse at home may keep (from July 2026)	At least $2,705 (more in Alaska and Hawaii), up to $4,066.50 Source: Centers for Medicare & Medicaid Services (source 4)

Dates, renewals and waiting lists

Dates and renewals
When coverage starts	The day you apply, or the first day of that month Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)
Back coverage, applications made by Dec 31, 2026	Up to 3 months before the month you apply, if you would have qualified then Source: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2)
Back coverage, applications made from Jan 1, 2027	Up to 2 months before the month you apply (1 month for the expansion adult group) Source: Centers for Medicare & Medicaid Services (source 5)

Good to know

Your state runs Medicaid within federal rules and may choose to cover more groups of people, so many states allow more than the federal minimums shown here.
After death, states must seek repayment from the estate of someone who got Medicaid at 55 or older for nursing home care, home and community care, and related hospital and drug costs. They can't while a spouse, a child under 21, or a blind or disabled child survives, and they must have a hardship waiver process.
States can't recover Medicare costs paid through a Medicare Savings Program.
If you need long-term care, giving away or selling things for less than they're worth in the five years before you apply can lead to a denial of that coverage.
Since Oct. 1, 2026, federal Medicaid funding for non-citizens is limited, with some exceptions, to lawful permanent residents, Cuban and Haitian entrants, and people from Compact of Free Association nations. Many lawful permanent residents also have a five-year waiting period. Emergency care is handled separately.
Immigration rules are complex. A free legal aid office near you can explain how they apply to you.

Sources: Medicaid.gov (Centers for Medicare & Medicaid Services) (source 2), Centers for Medicare & Medicaid Services (source 5), Legal Services Corporation (source 6)

What people get wrong

MythI have Medicare, so I can't get Medicaid too.
Not true. About 12 million people have both. Medicaid can pay Medicare costs and cover care Medicare doesn't.
MythMy income is too high, so there's no point applying.
Not always. In 36 states and DC, you can "spend down" by counting medical bills against your income.
MythIf I get Medicaid, the state will take my house while I'm alive.
Usually not. A lien during your lifetime is allowed only if you live permanently in a nursing home and no spouse or dependent child lives in the home. It must be lifted if you return home.