Yes, you can have both Medicare and Medicaid in Texas

You can hold both Medicare and Medicaid at the same time in Texas. People with both programs are called dual may be able to access. Texas allows this overlap, and in fact, many people benefit from having both because they cover different costs and services.

Medicare is a federal program based on age (65 and older) or disability status. Medicaid is a state program based on income and other factors. Because they are run by different agencies with different rules, you can meet the requirements for both simultaneously. Texas does not prevent this — it actually coordinates between the two programs when you have both.

The main reason people pursue dual coverage is that Medicare does not cover everything, and Medicaid can fill those gaps. For example, Medicare has copayments, deductibles, and coverage limits. Medicaid can pay some of those costs if you meet its income and resource limits.

Key Takeaways

  • Texas allows you to receive both Medicare and Medicaid at the same time if you meet the income and other requirements for each program.
  • Medicare covers people 65 and older or those with certain disabilities, while Medicaid in Texas covers people with low income and limited resources.
  • Having both programs means Medicaid can help pay Medicare premiums, deductibles, and copayments that Medicare does not cover.
  • You must meet Texas Medicaid income limits, which vary by household size and change each year.
  • If you are dual may be able to access, you may be able to join a special Medicare Advantage plan designed for people with both programs.

Income and resource limits for Texas Medicaid

To have Medicaid in Texas while also on Medicare, your income must fall below the state's limit. Texas uses different income thresholds depending on your age and whether you are in a long-term care facility or living in the community. The limits change yearly, so the exact dollar amount varies.

Texas also has resource limits — the total value of assets you can own and still receive Medicaid. Resources include savings accounts, investments, and property (though your home and one vehicle usually do not count). If your resources exceed the limit, you will not be approved for Medicaid, even if your income qualifies.

The best way to find the current income and resource limits is to contact the Texas Health and Human Services Commission directly or speak with a local Medicaid office. They can tell you whether your specific situation meets the requirements.

How Medicare and Medicaid work together

When you have both programs, they coordinate to pay your medical bills. Medicare is considered your primary insurance, meaning it pays first. Medicaid then pays some or all of what Medicare does not cover, depending on what services you receive and what Medicaid covers in Texas.

For example, if you see a doctor and Medicare covers 80 percent of the cost after you meet your deductible, Medicaid may pay part of the remaining 20 percent. This coordination reduces your out-of-pocket costs significantly compared to having Medicare alone.

Providers must accept both programs when you present both cards. Some providers may be unfamiliar with dual billing, so it helps to call ahead and confirm they accept both Medicare and Medicaid before your appointment.

Medicare Advantage plans for dual may be able to access people

If you are dual may be able to access in Texas, you may be able to join a Special Needs Plan (SNP), which is a type of Medicare Advantage plan designed specifically for people with both Medicare and Medicaid. These plans understand the coordination between the two programs and often offer extra benefits that Original Medicare does not include.

Some SNPs in Texas offer dental, vision, hearing aids, or transportation to medical appointments — services that can be valuable when your income is limited. However, not all SNPs are available in every part of Texas, and availability changes year to year.

To find SNPs available in your area, you can visit Medicare.gov or call Medicare at 1-800-MEDICARE. You can also contact the Texas Health and Human Services Commission to ask about plans in your region.

How to get both Medicare and Medicaid

If you already have Medicare, you can explore for Texas Medicaid through the Health and Human Services Commission. You can explore online at yourtexasbenefits.hhsc.texas.gov, by mail, in person at a local office, or by phone. The process asks about your income, resources, household size, and other factors.

If you do not yet have Medicare but will turn 65 soon, you should explore for Medicare first through Social Security. Once Medicare is active, you can then explore for Medicaid. If you are under 65 and disabled, you may be able to get Medicare after receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) for a certain period.

Processing times vary. Medicaid applications typically take 30 to 45 days, though this can be longer during busy periods. You will receive a notice in the mail telling you whether you are approved and what your coverage includes.

Common reasons people are denied Medicaid while on Medicare

The most common reason is income that exceeds the Texas limit. Even though Medicare does not have an income limit, Medicaid does. If your income is too high, you will not be approved, even if you have significant medical expenses.

Another reason is having too many resources. If your savings, investments, or other countable assets exceed the limit, Medicaid will deny your process. Some people spend down resources on medical care or other allowed expenses to bring themselves under the limit, but this requires careful planning.

A third reason is not meeting other Medicaid requirements, such as being a Texas resident or a U.S. citizen or may have access to immigrant. Make sure you meet all the basic requirements before you explore.

What services Medicaid covers that Medicare does not

In Texas, Medicaid covers some services that Medicare does not pay for, which is one reason dual may be able to access people benefit from having both. Medicaid covers long-term care in nursing homes, personal care information at home, and some dental and vision services. Medicare has limited coverage for these services or does not cover them at all.

Medicaid also covers prescription drugs through a separate program called Texas Medicaid Pharmacy. If you are on Medicare, you need a separate Part D plan for drug coverage, and that plan has its own costs and restrictions. Having Medicaid can reduce your drug costs.

Additionally, Medicaid can pay your Medicare premiums, deductibles, and copayments if you are dual may be able to access. This is called cost-sharing information, and it can save you hundreds of dollars per year.

Frequently Asked Questions

Do I lose Medicare if I get Medicaid?

No. Medicare and Medicaid are separate programs, and getting Medicaid does not affect your Medicare coverage. You keep both at the same time. Your Medicare benefits continue exactly as they were before you were approved for Medicaid.

Will Medicaid take my house or savings if I am dual may be able to access?

Medicaid has resource limits, but your primary home and one vehicle are usually not counted as resources. However, savings and other assets do count. If you have concerns about protecting assets, speak with a Medicaid caseworker or a legal aid attorney about your specific situation.

Can I choose Original Medicare or Medicare Advantage if I have Medicaid?

Yes, you can choose either. However, if you are dual may be able to access, a Special Needs Plan (SNP) may offer better coordination with Medicaid and additional benefits. You can switch plans during the annual enrollment period, which runs from October 15 to December 7 each year.

What happens to my Medicaid if my income increases?

If your income rises above the Texas Medicaid limit, you may lose Medicaid coverage. You should report income changes to the Health and Human Services Commission right away. Some people become ineligible temporarily but can reapply later if their income drops again.

How do I know if I am dual may be able to access?

You are dual may be able to access if you have both an active Medicare card and an active Medicaid card from Texas. If you have Medicare but are not sure about Medicaid, contact the Texas Health and Human Services Commission or visit yourtexasbenefits.hhsc.texas.gov to check your status.