Yes, you can have Medicare and Medicaid at the same time. Millions of people do: by the federal government's own count, more than 13 million people were enrolled in both programs during 2022. Having both is often called being "dual eligible," and it can mean Medicaid pays your Medicare premiums, your deductibles, even your copays, and that some bills are not allowed to be sent to you at all. This guide explains, in plain English, how the two programs fit together, the 2026 income limits, the help many people never claim, and the bills you should never pay. (Full disclosure: Slothwise, the company behind this site, makes a health app listed in the Medicare App Library on Medicare.gov. More on that near the end.)

How Medicare and Medicaid fit together

Medicare is the federal health insurance you get at 65 or through disability. Medicaid is the state-run program for people with limited income and resources. When you qualify for both, they stack: Medicare pays first for your medical care, and Medicaid steps in behind it.

How much Medicaid steps in depends on which door you qualify through:

• Full Medicaid plus Medicare. About three quarters of people with both have full Medicaid benefits alongside Medicare. Medicaid covers things Medicare does not, and helps with Medicare's costs.

• Help with Medicare costs only. The rest get Medicaid help through the Medicare Savings Programs, which pay Medicare premiums and, in some cases, deductibles and copays, without full Medicaid coverage.

Either way, you keep your Medicare. Having Medicaid or a Medicare Savings Program never takes your Medicare away.

The four Medicare Savings Programs, with 2026 limits

Every state must offer these. The federal monthly income limits below are for 2026 and already include a standard $20 disregard; they are slightly higher in Alaska and Hawaii, they go up each year, and some states set more generous limits than the federal floor. All figures are from Medicare's official page.

• QMB (Qualified Medicare Beneficiary). Income up to $1,350 a month for an individual, $1,824 for a couple; resources up to $9,950 / $14,910. Pays your Part A premium if you have one, your Part B premium, and your Medicare deductibles, coinsurance, and copayments. With the Part B premium at $202.90 a month in 2026, this alone is worth over $2,400 a year before a single deductible.

• SLMB (Specified Low-Income Medicare Beneficiary). Income up to $1,616 / $2,184 a month; same resource limits. Pays your Part B premium.

• QI (Qualifying Individual). Income up to $1,816 / $2,455 a month; same resource limits. Pays your Part B premium. You reapply each year, and states approve applications first come, first served, with priority for people who had QI the year before.

• QDWI exists for certain working people under 65 with a disability who lost premium-free Part A; if that is not your situation, you can ignore it.

Qualifying for QMB, SLMB, or QI also automatically brings you Extra Help with prescription drugs, covered next.

What counts toward the limits? Income is most of what comes in monthly. For resources, Medicare's page counts money in checking, savings, or retirement accounts, plus stocks and bonds. States do not count your home, one car, a burial plot, up to $1,500 set aside for burial, furniture, or household and personal items. Your house and your car do not disqualify you.

And in Medicare's own words: "Even if you don't think you qualify, you should still apply."

The bill you should never pay

This is the single most valuable thing to know if you are in the QMB program, and many people who are in it have never been told: it is against the law for Medicare providers to bill you for services and items Medicare covers. No deductibles, no coinsurance, no copayments. Not from your doctor, not from the hospital, not from any provider that takes Medicare, whether or not they take Medicaid, in any state. You cannot even volunteer to pay these amounts, and a provider who billed you anyway is required to recall the bill, including from a collection agency, and refund what you paid.

The federal government admits this still goes wrong: CMS itself says some providers continue to improperly bill people in QMB, and many people pay because they do not know the rule. So if you have QMB and a bill arrives for a Medicare-covered service, treat it as an error, not a debt:

1. Tell the provider you are in the QMB program. Show both your Medicare card and your Medicaid or QMB card whenever you get care. Your Medicare Summary Notice also states you are in QMB and shows your cost as zero.

2. If the bills keep coming, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). They will confirm your QMB status, tell the provider to stop, and ask them to refund anything you already paid.

3. If a debt collector is involved, file a complaint with the Consumer Financial Protection Bureau at consumerfinance.gov/complaint or 1-855-411-2372.

Two small exceptions are normal and not violations: a small Medicaid copay where your state charges one, and your regular prescription copays at the pharmacy, which fall under Extra Help rules below. For the full law, the refund rules, and every exception, see our deep dive on the QMB billing protection.

Extra Help with prescription drugs

Extra Help is the Medicare program that cuts prescription drug costs, and Social Security estimates it is worth about $5,700 a year. In 2026, the income limit is $23,940 a year for an individual and $32,460 for a married couple, with resource limits of $18,090 and $36,100. The limits go up each year, and you may still qualify above them in some situations, so the same rule applies: apply even if you are not sure.

What you pay with Extra Help in 2026: no plan premium, no deductible, at most $5.10 for a generic and $12.65 for a brand-name drug, and nothing at all once your total drug costs reach $2,100 for the year. If you have full Medicaid and QMB, your cap is even lower, at $4.90 per drug. There is no late enrollment penalty while you have Extra Help, and you can apply at any time of year.

You may already have it without applying. If you have full Medicaid, or a Medicare Savings Program pays your Part B premium, or you get SSI, you get Extra Help automatically, and Medicare enrolls you in a drug plan if you do not have one.

One application can start everything

Two shortcuts are built into the system, and they matter:

• Applying for Extra Help also starts a Medicare Savings Program application. When you apply through Social Security, your information goes to your state to begin an MSP application unless you say no on the form. One application, both programs.

• If you get SSI, most states now must enroll you in QMB automatically, with no application at all.

How to apply

• Medicare Savings Programs: through your state Medicaid office. The programs are run by your state, and your state decides which one you qualify for. Call your state Medicaid agency, or call 1-800-MEDICARE and ask how to reach it.

• Extra Help: through Social Security. Apply online at ssa.gov/medicare/part-d-extra-help, or call 1-800-772-1213 (TTY 1-800-325-0778), weekdays 8 a.m. to 7 p.m., or visit a local office. Before you start, gather bank statements and tax returns, IRA or 401(k) balances, and statements for pensions, veterans benefits, annuities, or Railroad Retirement.

• Free one-on-one help: your SHIP. Every state has a State Health Insurance Assistance Program offering free, unbiased counseling, including help with these applications. Find yours at shiphelp.org or call 877-839-2675.

Millions of people leave this money unclaimed

If you suspect you might qualify but assume programs like these are not for you, consider the government's own numbers: only about half of the people eligible for the Medicare Savings Programs are enrolled, and millions of people eligible for Extra Help are not receiving it. This help exists precisely because Medicare's premiums and copays take a real bite out of a fixed income. Applying costs nothing, and the worst outcome is a no.

Common questions

Will Medicaid take my house? Not while you are alive, and the rules are narrower than the fear. Estate recovery applies after death, mainly for long-term care costs like nursing home care for people 55 and older, and it cannot happen while your spouse, a child under 21, or a blind or disabled child survives you. Just as important: money a Medicare Savings Program paid toward your Medicare costs is excluded from estate recovery by federal rule. Enrolling in QMB, SLMB, or QI does not put your home at risk. Our calm guide to estate recovery covers the full rules.

Do the new Medicaid work requirements apply to me? No. The federal rule applies only to adults age 19 to 64 who are not on Medicare. If you are 65 or older, or you have Medicare at any age, you are outside the requirement entirely, and states are expected to see your Medicare status automatically in their records. Nothing about it takes effect before 2027 anywhere. We cover the rule and who it actually affects in full.

I got a Medicaid renewal letter. Should I worry? No, but do not ignore it. Renewals are routine, and the main way people lose Medicaid or a Medicare Savings Program is simply not responding by the deadline. If the paperwork is confusing, your SHIP will help you with it for free.

Will I lose my doctors? Enrolling in a Medicare Savings Program does not change your Medicare or your doctors; it changes who pays your Medicare costs. The QMB billing protection applies at every provider that takes Medicare, in every state.

A doctor's office says they don't take Medicaid, so I have to pay my Medicare copay. True? Not if you are in QMB. The law binds every Medicare provider, including those that do not take Medicaid, even when Medicaid pays them nothing. The steps above apply.

Do I have to join a special insurance plan? No. Some duals choose a Dual Eligible Special Needs Plan (D-SNP), a Medicare Advantage plan built for people with both programs, but it is optional, and most people with both programs are not in one. Starting in 2027, these plans will be required to work more smoothly, including one membership card instead of two. Take your time; free advice from your SHIP beats any sales call.

My income is a little over the limit. Is it pointless to apply? No. Some states set higher limits or ignore more of your income, several things do not count toward the limits at all, and the limits rise every year. Medicare's own advice is to apply even if you do not think you qualify.

How can Slothwise help?

Slothwise brings your Medicare claims, medical records, and bills together in one place and points out anything that looks wrong, in plain English, so a charge you were never supposed to receive does not slip through just because it looked official. If a statement confuses you, or you help a parent who gets both Medicare and Medicaid, you can simply ask it. You can use it in the app or right from your text messages, and it is free to start, with no credit card. Our guide to catching medical bill errors walks through the same checks by hand.

Slothwise is one option, not the only one. For enrolling in these programs and for coverage questions, the free official help is the right first call: your state Medicaid office, your local SHIP at 877-839-2675, or 1-800-MEDICARE. And for everything changing in Medicare this year, see our 2026 roundup.

The short version

• Yes, you can have both. Millions do, and every state must offer the Medicare Savings Programs.

• In 2026, QMB, SLMB, and QI reach up to $1,816 a month in income for an individual ($2,455 for couples) and pay some or all of your Medicare costs; Extra Help reaches $23,940 a year ($32,460 for couples) and caps drug copays at a few dollars. Your house and car do not count.

• If you are in QMB, providers are not allowed to bill you for Medicare-covered care, period. Treat such a bill as an error and call 1-800-MEDICARE if it keeps coming.

• One Extra Help application through Social Security can start your Medicare Savings Program application too. Only about half of eligible people are enrolled. Apply even if you are not sure.

Slothwise is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency, and does not sell, endorse, or recommend any Medicare plan. This article is general information, not legal, financial, or medical advice. For questions about your specific coverage, contact 1-800-MEDICARE, your State Health Insurance Assistance Program (SHIP), or a qualified professional. Last updated: July 2026.