Guide
Have Medicare and Medicaid? What changes, and how an agent can help
Millions of people with Medicare also qualify for Medicaid. Having both can lower your costs a lot, and it opens options other people don't have. It also makes you a target for aggressive sales calls, so it pays to know the rules.
Last reviewed October 26, 2026. General information, not advice about any plan.
Help with costs
- Medicaid
- Your state's program can cover costs Medicare doesn't, and sometimes your Medicare premiums and copays.
- Medicare Savings Programs
- State programs that help pay Part B premiums, and sometimes deductibles and copays, for people with limited income.
- Extra Help
- Lowers Part D drug costs. If you have Medicaid or a Medicare Savings Program, you usually qualify automatically.
Plans built for people with both
Many areas have Dual Eligible Special Needs Plans (D-SNPs): Medicare Advantage plans only for people with both Medicare and Medicaid. Some are fully integrated with your state's Medicaid, so one plan handles both, with one card and one number to call. Availability and how integrated they are vary by state and county.
When you can change plans
- Every month: a standalone drug plan
- With Medicaid or Extra Help, you can switch once a month to Original Medicare with a standalone Part D plan. Since 2025, this can't be used to join or switch Medicare Advantage plans.
- Every month: integrated plans
- With full Medicaid, you can join certain integrated plans that cover both Medicare and Medicaid in any month.
- Usual enrollment periods
- Other changes, like switching between Medicare Advantage plans, follow the fall Annual Enrollment Period and other usual windows.
These rules are newer than much of what's online. See all the enrollment periods.
What to watch for
- Calls you didn't ask for promising "new benefits" or grocery money if you switch. Agents can't cold-call you to sell plans.
- Being switched plans month after month. Each change can mean new networks and new rules for your prescriptions.
- Anyone who says changing plans won't affect your Medicaid without checking. Confirm with your state Medicaid office.
Working with an agent? Check their license, and ask how many companies they represent and which plans in your area are built for people with both Medicare and Medicaid.
Common questions
What does dual eligible mean?
It means you qualify for both Medicare and your state's Medicaid program. Some people get full Medicaid benefits; others get help only with Medicare premiums and costs through a Medicare Savings Program.
Can I change my plan any month if I have Medicaid?
Partly. Since 2025, people with Medicaid or Extra Help can switch once a month into a standalone Part D drug plan with Original Medicare. People with full Medicaid can also join certain integrated plans for both programs in any month. Other Medicare Advantage changes follow the usual enrollment periods.
Do I lose Medicaid if I join a Medicare Advantage plan?
No. Medicaid stays separate, though some plans are designed to coordinate both. Check with your state Medicaid office before changing anything.
Who can help for free?
Your state's SHIP counselors, your Medicaid office, and 1-800-MEDICARE. A licensed agent who works with plans for people with both can also compare options at no cost to you.
Keep reading
- Medicare enrollment periods: when you can sign up or switchEvery Medicare enrollment window in one place: turning 65, the fall Annual Enrollment Period, the January–March change, Medigap open enrollment, special periods and late penalties.
- Extra Help and Medicare Savings Programs: who qualifies and how to applyTwo programs that cut Medicare costs for people with limited income: Extra Help for drug costs and state Medicare Savings Programs for premiums. The 2026 limits, what they pay, and how to apply for both at once.
- Does Medicare cover nursing home care? Skilled nursing vs. long-term careMedicare covers short-term skilled nursing facility care after a qualifying hospital stay, up to 100 days, but not long-term nursing home care. The 3-day rule, 2026 costs, and what to do when coverage ends.
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