Is it okay to have Medicaid and private insurance?
Asked by: Gideon Beier IV | Last update: October 23, 2025Score: 4.4/5 (33 votes)
What happens if you have Medicaid and private insurance?
You can have Medicaid and private health insurance at the same time, and there are some advantages and disadvantages to doing so. In many cases, if you're eligible for both Medicaid and private insurance, your private insurance plan will be the primary coverage, and your Medicaid coverage will be supplemental.
Can you have medical and private insurance at the same time?
Medi-Cal managed care plans do not stop beneficiaries from enrolling in private health insurance plans. If a Medi-Cal beneficiary is currently enrolled in a Medi-Cal managed care plan, and subsequently purchases private health insurance, they will not be disenrolled from the Medi-Cal managed care plan.
Can I private pay if I have Medicaid?
(a) A provider may refuse to accept a patient as a Medicaid patient and bill the patient as a private pay patient only if the provider informs the patient that the provider will not bill Medicaid for any services or supplies but will charge the patient for all services or supplies provided.
Can you have both public and private health insurance?
There are several scenarios in which someone may be covered by multiple health insurance plans, including: An individual might supplement their private health insurance plan with a government program, such as Medicaid or Medicare.
Should I keep my health insurance when I apply for Medicaid?
Is it OK to have 2 health insurances?
Can I have 2 health insurance plans at the same time? Yes. A process called coordination of benefits determines which insurance plan will pay first. Your primary plan will pay for the health claim first, paying the costs up to the plan's coverage limits, and then your second plan will kick in.
Is it illegal to have two types of health insurance?
Most individuals only have one health insurance plan, known as “primary” insurance. However, some people also secure additional medical coverage or a “secondary” insurance plan. Having dual coverage is perfectly legal.
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.
Can you bill a patient if they have Medicaid?
If you have Medicaid, a doctor or hospital who accepts Medicaid is prohibited from balance billing you for services that Medicaid covers.
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.
What is the best secondary insurance if you have Medicare?
- Best for extra plan benefits: Humana.
- Best for straightforward coverage: State Farm.
- Best for extensive medical care coverage: AARP by UnitedHealthcare.
- Best for a range of Medigap plans: Blue Cross Blue Shield.
Can I opt out of Medicare if I have private insurance?
Yes, you can choose to opt out of Medicare coverage, but it's important to consider potential drawbacks. Medicare offers essential healthcare benefits, and opting out might leave you without coverage for certain medical expenses.
How to tell which insurance is primary?
The insurance that pays first is called the primary payer. The primary payer pays up to the limits of its coverage. The insurance that pays second is called the secondary payer. The secondary payer only pays if there are costs the primary insurer didn't cover.
What are the disadvantages of having Medicaid?
- Lower reimbursements and reduced revenue. Every medical practice needs to make a profit to stay in business, but medical practices that have a large Medicaid patient base tend to be less profitable. ...
- Administrative overhead. ...
- Extensive patient base. ...
- Medicaid can help get new practices established.
Does Medicaid cover 100% of hospital bills?
What Medicaid Covers. Once an individual is deemed eligible for Medicaid coverage, generally there are no, or only very small, monthly payments, co-pays or deductibles. The program pays almost the full amount for health and long-term care, provided the medical service supplier is Medicaid-certified.
Are you allowed to have Medicare and private insurance?
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."
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.
Why can't Medicaid patients pay cash?
Based on ASHA's review of Medicaid programs, most Medicaid agencies do not allow Medicaid-enrolled providers to accept cash pay from Medicaid beneficiaries. The Medicaid program expects enrolled providers to observe the terms of their enrollment contract, including reimbursement rates and methods of remuneration.
Do I need Medicare if I have Medicaid?
People who qualify for both Medicare and Medicaid are called “dual eligible.” If you're dual eligible, your Medicaid and Medicare plan(s) will work together to provide coverage for your needs. In most cases, Medicare will be your primary plan and cover most Medicare-eligible healthcare services.
Can you have Medicaid and employer insurance at the same time?
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.
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.
Can you have medical and private insurance?
Even if you have other health coverage such as health insurance from your work, you may still qualify for Medi-Cal. If you qualify, Medi-Cal will cover allowable costs not paid by your primary insurance. Under federal law, Medi-Cal beneficiaries' private health insurance must be billed first before billing Medi-Cal.
Can you be covered by 2 insurances?
Yes, you can have two health insurance plans and it is perfectly legal, but it is also important to fully understand how primary vs secondary insurance operates.
Can you have Medicaid and marketplace insurance at the same time?
Keeping both Marketplace and Medicaid and CHIP
If you have qualifying health coverage through Medicaid or CHIP coverage, you'll pay full price for your Marketplace plan premium and covered services.