Q: Can I be enrolled in Medicare and Medicaid at the same time?
A: In certain cases, yes. Some people do qualify for both Medicare and Medicaid, and in those instances, most of the enrollee’s health care costs are covered. People who are eligible for Medicaid and Medicare are known as dual eligible; about 20 percent of Medicare beneficiaries are also eligible for Medicaid. They can be eligible for full Medicaid in addition to Medicare, or for Medicare and an income-based Medicare Savings Program.
When dual eligible beneficiaries have claims, Medicare pays first and Medicaid is secondary.
Eligibility for full Medicaid is determined by the state, while Medicare eligibility is handled by the federal government. Many low-income seniors who are in nursing homes are dual eligible – qualifying for Medicare based on their age, and for Medicaid (which pays for their custodial care that Medicare does not cover) based on their low income and asset level.