Medicaid
Medicaid and Medicare: your complete guide
Understand Medicaid eligibility, dual-coverage options, and how Medicaid can help reduce your healthcare costs in retirement.
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Understanding Medicaid
Medicaid is a joint federal and state program that provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, older adults, and people with disabilities. Each state runs its own program within federal guidelines.
Medicaid eligibility requirements
Medicaid eligibility varies by state but generally considers income, household size, disability status, and other factors. The Affordable Care Act expanded Medicaid eligibility in many states.
| Household size | Medicaid (138% FPL) | Medicare Savings Programs (up to 135% FPL) |
|---|---|---|
| Individual | Up to $20,120/year | Up to $19,683/year |
| Couple | Up to $27,214/year | Up to $26,622/year |
| Family of 3 | Up to $34,307/year | Varies by state |
| Family of 4 | Up to $41,400/year | Varies by state |
Income limits and eligibility criteria vary significantly by state. Some states expanded Medicaid under the ACA; others did not. Always check your state's specific requirements.
Dual eligible: Medicare + Medicaid
"Dual eligible" refers to people who qualify for both Medicare and Medicaid. These beneficiaries typically have the most comprehensive coverage available, with Medicaid helping to cover costs that Medicare doesn't.
Medicare pays for
- Hospital stays (Part A)
- Doctor visits (Part B)
- Prescription drugs (Part D)
- Preventive services
Medicaid helps with
- Medicare premiums
- Deductibles and copays
- Long-term care services
- Dental, vision, and hearing
Medicare Savings Programs (MSP)
Pays Part A and B premiums, deductibles, and copays
Pays Part B premium only
Pays Part B premium (higher income limit)
Helps with Part D drug costs
What Medicaid covers
Medicaid provides comprehensive coverage that often exceeds what Medicare alone offers. Benefits vary by state, but federal law requires certain mandatory services.
Hospital Services
Medical Services
Long-Term Care
Additional Benefits
Mental Health
Transportation
How to apply for Medicaid
You can apply for Medicaid through your state Medicaid office, at Healthcare.gov, or with help from community organizations.
Gather documents
Proof of income, ID, residency, and citizenship status
Choose your application method
Online, by phone, in person, or by mail
Complete the application
Provide all required information accurately
Submit and wait
Processing typically takes 45 days or less
Receive the decision
You will receive a notification with coverage details