Medicare and Medicaid together
Dual Eligible Medicare and Medicaid in 2027
If you qualify for both Medicare and Medicaid, your coverage and costs depend on your Medicaid category, state rules and the Medicare plan you choose.
What dual eligible means
Dual eligible generally means you qualify for Medicare and also receive Medicaid or help through a Medicare Savings Program. Medicare and Medicaid have different eligibility rules, and Medicaid rules vary by state.
Full Medicaid and Medicare Savings Programs are different
Some people qualify for full Medicaid benefits in addition to Medicare. Others qualify for a Medicare Savings Program that can help with certain Medicare costs without providing the full range of Medicaid benefits. Your exact category matters.
Prescription drug help
People who qualify for Medicaid or a Medicare Savings Program commonly qualify for Extra Help with Medicare Part D prescription drug costs. The amount of help depends on your eligibility status and current federal rules.
Dual Eligible Special Needs Plans
A D-SNP is a Medicare Advantage Special Needs Plan designed for people who meet specific Medicare and Medicaid eligibility requirements. D-SNP availability, Medicaid integration, provider networks, drug coverage and supplemental benefits vary by plan and service area.
Do not assume every D-SNP includes the same extras
Food, grocery, utility, transportation, over-the-counter or flex-card benefits are not universal. When offered, they can depend on the specific plan, eligibility criteria and benefit rules. Review the current plan documents before enrolling.
Enrollment can be more flexible
People with Medicaid, Extra Help or certain other qualifying circumstances may have Special Enrollment Period opportunities outside the annual Medicare enrollment window. The timing and frequency depend on current Medicare rules and your situation.
How to verify eligibility
- Confirm your current Medicaid or Medicare Savings Program status with your state Medicaid agency.
- Confirm Extra Help status through Social Security or Medicare if needed.
- Before joining a D-SNP, verify that your Medicaid category meets the plan’s eligibility requirements.
- Check your doctors, prescriptions and preferred pharmacies against the specific plan.
Does everyone with Medicaid qualify for the same D-SNP?
No. Eligibility depends on the plan’s requirements, your Medicaid category and the plan’s service area.
Do all dual eligible plans include grocery or utility benefits?
No. Supplemental benefits vary by plan and can have separate eligibility conditions.
Review your 2027 dual eligible options
Get no-cost help comparing represented D-SNP and other Medicare options after confirming your eligibility.