What Happens to Medicaid When Medicare Begins?

Turning 65 or becoming Medicare eligible does not automatically mean you lose Medicaid. What changes is how Medicaid determines eligibility. Once someone becomes eligible for Medicare, they may be evaluated under different Medicaid rules, including income and resource requirements.

If someone no longer qualifies for full Medicaid, don’t assume they have to pay all their Medicare costs themselves. They may qualify for a Medicare Savings Program (MSP):

• QMB: Can help with Medicare premiums, deductibles, coinsurance, and copayments.
• SLMB: Helps pay the Medicare Part B premium.
• QI: Also helps pay Part B premium and generally allows a higher income than SLMB.
• QDWI: Helps certain working individuals with disabilities pay their Part A premium.
• They may also qualify for Extra Help, which can reduce Medicare prescription drug costs.

The trick is knowing which program you may qualify for and what assistance you’re entitled to. Someone might say, “I’m losing Medicaid when I turn 65,” when they may be transitioning to Medicare while still qualifying for valuable Medicaid assistance.

That’s why it’s important to have your Medicare, Medicaid, income, and available assistance reviewed together not separately.

Bottom line: Don’t assume turning 65 means losing your help with Medicare costs. Know what you qualify for before you decide. If you’re approaching Medicare eligibility or recently lost Medicaid, reach us here at the Health Insurance Store for a personalized review of your options.

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