Can you have both Medicaid and employer insurance?
Asked by: Trisha Streich | Last update: November 21, 2025Score: 4.1/5 (34 votes)
Can you have Medicaid and work insurance at the same time?
Can I use Medicaid as secondary insurance after my insurance through my employer? Yes, you can maintain your employer-sponsored insurance plan as your primary coverage while also qualifying for Medicaid, which would pay for, generally speaking, any qualifying expense that your primary plan doesn't cover.
Is it illegal to have Medicaid and employer insurance?
The simple answer to the question of “can you have both Medicaid and private insurance?” is a resounding “YES”!
Can you have Medicaid and be employed?
A large majority of adult Medicaid beneficiaries who can work already do. Before the COVID-19 pandemic, 62 percent of adult Medicaid beneficiaries who were not enrolled in Medicare and did not meet Social Security disability criteria were either working or in school.
Can you own a business and be on Medicaid?
While the simple answer is, “yes”, one can own a business (be self-employed) and still be eligible for Medicaid, the topic is more complicated. Certain factors, some state-specific, come into play when determining if business assets are counted towards Medicaid's asset limit.
Can You Have Medicaid And Private Insurance? - CountyOffice.org
What happens if you win money while on Medicaid?
Winning the lottery generally doesn't require you to pay back Medicaid costs. However, it can affect your eligibility for Medicaid, as eligibility often depends on income levels, which vary by state. You might lose your benefits if your lottery winnings push your income above the Medicaid threshold.
Can I have insurance and Medicaid?
Generally yes, as long as you qualify to use the Marketplace. Most people whose incomes are just above the level to qualify for Medicaid can pay very low premiums and out-of-pocket costs for private health insurance through the Marketplace. Check if you'll qualify for savings.
Do I have to get Medicare if I have employer coverage?
If an employer has fewer than 20 employees, generally you will need to enroll in Medicare during your Initial Enrollment Period. If you have health coverage through a spouse's employer, what you can do will depend on the employer's rules. You may be able to delay or you may need to enroll at age 65.
Is Medicaid better than employer insurance?
Medicaid provides more comprehensive benefits than private insurance at significantly lower out-of-pocket cost to beneficiaries, but its lower payment rates to health care providers and lower administrative costs make the program very efficient.
Can you have medical and employer insurance at the same time?
Medi-Cal and Employer-Sponsored Health Coverage
Note: You can choose to get Medi-Cal even if you have employer-sponsored coverage. If you have both at the same time, Medi-Cal may decide it is cost-effective for them to pay your portion of your employer-sponsored health insurance's premium.
Can I drop my employer health insurance for Medicare?
For example, you may be able to: Drop your employer coverage and enroll in Original Medicare, Part A and Part B. If you take this route, you might want to think about signing up for prescription drug coverage under Medicare Part D, and/or buying a Medicare Supplement Insurance plan.
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.
What are the four types of Medicaid?
- State-operated fee-for-service (FFS)
- Primary care case management (PCCM)
- Comprehensive risk-based managed care (MCO model)
- Limited-benefit plans.
Can you use Medicare and private insurance at the same time?
If you have Medicare and other health insurance (like from a group health plan, retiree coverage, or Medicaid), each type of coverage is called a "payer." The "primary payer" pays up to the limits of its coverage, then sends the rest of the balance to the "secondary payer."
Can I deny Medicaid coverage?
If you were found eligible for Medicaid but do not wish to enroll, you will need to fill out the Decline Medicaid Coverage Form available here. Declining Medicaid will not change your eligibility for advance premium tax credits or cost-sharing reductions to use to purchase a private health insurance plan.
Can you be on Medicaid and still work?
After you start working, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high to receive SSI.
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Can I have an employer plan and a Medicare Advantage plan?
In other cases, if you join a Medicare Advantage Plan, you may still be able to use your employer or union coverage along with the Medicare Advantage Plan you join. Your employer or union may also offer a Medicare Advantage retiree health plan that they sponsor.
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.
How often does Medicaid check your income?
Yes, income and assets have to be verified again for Medicaid Redetermination. After initial acceptance into the Medicaid program, redetermination is generally every 12 months. The redetermination process is meant to ensure the senior Medicaid beneficiary still meets the eligibility criteria, such as income and assets.
Is it illegal to pay out of pocket if you have Medicaid?
Out of pocket costs cannot be imposed for emergency services, family planning services, pregnancy-related services, or preventive services for children. Generally, out of pocket costs apply to all Medicaid enrollees except those specifically exempted by law and most are limited to nominal amounts.
How much tax do you pay if you win $5000?
The IRS requires that lottery agencies immediately withhold a 24% tax on lottery winnings exceeding $5,000, which reduces your actual take-home prize amount.
Can you inherit money while on Medicaid?
This means the individual is not eligible for Medicaid until the “excess” assets (the assets over Medicaid's asset limit) are “spent down”. California is the only state without an asset limit (eff. 1/1/24). Medi-Cal beneficiaries can have unlimited assets and still be eligible for benefits.