Can I have Medicare and Medicaid in Virginia?
Asked by: Erin Herman | Last update: January 22, 2026Score: 4.5/5 (21 votes)
Can you have both Medicare and Medicaid in Virginia?
If you are eligible for or have Medicare, you can choose a Dual Eligible Special Needs Plan (D-SNP) for your Medicare health coverage. A D-SNP is a Medicare Advantage plan. It works with your Medicaid health plan.
Who is eligible for Medicare and Medicaid in Virginia?
Adults who are 65 or older, disabled, or blind may qualify for full Medicaid. These adults must have income and resources within certain limits. A person with income over the Medicaid limit who needs long-term care or has high medical costs may still qualify for Medicaid through a Medically Needy spenddown.
Will I lose my Medicaid if I get Medicare?
People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you're a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.
Who can have both Medicare and Medicaid?
To be eligible to receive both Medicare and Medicaid, a person must qualify for either partial-dual or full-dual coverage. Eligibility for partial-dual coverage depends on the support that a person receives from Medicaid. Examples of the varied coverage may include: Part A premium (if applicable)
How Medicaid Works with Medicare | Are you Dual Eligible?
How many people are dual eligible for Medicare and Medicaid?
They qualify for Medicare because they're at least 65 years old or because they're under age 65 and have a qualifying disability or medical condition. They qualify for Medicaid because they have low income and few resources. In 2024, about 12.8 million Americans are dual-eligible beneficiaries.
Can you have Medicaid and private insurance at the same time in 2024?
The simple answer to the question of “can you have both Medicaid and private insurance?” is a resounding “YES”! Medicaid is given to low-income U.S citizens in need and will not be disputed due to already enrolled in a private health insurance program.
Is it better to be on Medicare or Medicaid?
While Medicare is the primary payer for medical needs, Medicaid can cover costs that Medicare coverage does not. When you visit a provider that takes both Medicare and Medicaid, Medicare pays first for the cost of your care. Medicaid pays second, covering copays and other costs not covered.
How much does Medicaid cost per month?
Amounts. Most states adjust premium amounts by beneficiary income, with approved possible charges ranging from approximately $5 to $74 per month. Four states (AR, AZ, MI, and MT) have approved waivers to require monthly premium payments as a percentage of income.
Will Medicaid take my social security check?
It is essential to know that Social Security benefits are not exempt from Medicaid. Payments you receive from Social Security are counted as income. Nevertheless, you are not automatically barred from obtaining Medicaid coverage just because you receive Social Security benefits.
What disqualifies you from Medicaid?
In general, a single person must have no more than $2,000 in cash assets to qualify. If you're over 65, the requirements are more complex. Whatever your age, there are strict rules about asset transfers. Medicaid may take into consideration any gifts or transfers of cash you've made recently.
How much money can you have in the bank with Medicaid in Virginia?
Have countable resources of not more than $2,000 for one person or $3,000 for a couple. Resources are things such as bank accounts (checking, savings, certificates of deposit, Christmas club, etc.), stocks, bonds, the cash value of some life insurance policies, property that does not adjoin your home, etc.
Can you have Medicare Medicaid and VA benefits?
If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits along with these plans. Learn more about how VA works with other health insurance.
How often does Medicaid check your bank account?
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
What is Virginia's Medicaid income limit?
Virginia has very restrictive Medicaid eligibility: Pregnant women and children through age 18 cannot have income higher than 148 percent of federal poverty level (FPL) or $30,240 for a family of three. (Virginia's FAMIS program covers children and pregnant women up to 205 percent FPL or $41,880 for a family of three.)
What is the difference between Medicaid and Medicare in Virginia?
Medicare is health coverage for people ages 65 or older and those of any age who were found disabled under Social Security rules. Medicaid is health coverage for individuals and families who meet income limits and other rules based on financial need.
Who pays for Medicare and Medicaid?
Funding for Medicare comes from payroll taxes and premiums paid by recipients. Medicaid is funded by the federal government and each state. Both programs received additional funding as part of the fiscal relief package in response to the 2020 economic crisis.
What does Medicaid not cover?
Though Medicaid covers a wide range of services, there are limitations on certain types of care, such as infertility treatments, elective abortions, and some types of alternative medicine. For example, the federal government lists family planning as a mandatory service benefit, but states interpret this differently.
What happens if you make too much money while on Medicaid?
If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.
Why do some people have both Medicare and Medicaid?
Medicare-Medicaid enrollees include people ages 65 and over who are in relatively good health but have limited financial resources and people who at one time, may have had more financial resources, but spent their income and wealth on health or long-term care costs.
What is the downside of Medicaid?
Disadvantages of Medicaid
One of the primary reasons for this is that Medicaid reimbursements are lower than those of commercial insurers for most procedures and treatments.
Who qualifies for Medicare and Medicaid?
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.
Can you have Medicaid and private insurance in Virginia?
It depends. Some Medicaid programs will not allow an individual to have both, while it is allowable for other programs, such as those for an aged, blind or disabled person.
Who is not eligible for Obamacare?
Must live in the United States. Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses. Cannot be incarcerated in prison or jail.
What is the birthday rule used to determine?
The birthday rule determines the order that the insurance companies will pay benefits when a dependent child is covered by two health insurance plans. The health insurance plan of the parent whose birthday month and day occurs earlier in the calendar year is primary.