What happens to my Medicaid when I turn 65?

Asked by: Carmel Nicolas  |  Last update: January 16, 2026
Score: 4.6/5 (8 votes)

To be clear, Medicaid remains available after age 65 and many older adults rely on it — for example, the majority of nursing home residents in the United States have Medicaid coverage in addition to their Medicare coverage. But once you turn 65, eligibility for Medicaid is based on both income and assets.

What happens to someone on Medicaid when they turn 65?

Therefore, following the ACA's coverage expansion, many newly-insured older enrollees will face a complex insurance transition on their 65th birthday: they will lose Medicaid coverage and transition from Medicaid to Medicare as their primary insurer.

Do I automatically get Medicare when I turn 65?

You'll get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) automatically when you turn 65. You'll still need to make important decisions about your coverage, like whether you need to add drug coverage.

What is the highest income to qualify for Medicaid in PA?

This income limit, now $2,829/month, normally changes on January 1st of each year. This monthly figure represents 300% of the federal SSI benefit amount and is usually revised upwards each year due to inflation. $2,829 is the income threshold amount for 2024.

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.

I Have Medicaid: What Happens When I Turn 65?!

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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 money can you have in the bank on Medicaid in PA?

The MNO-MA asset limits are $2,400 for an individual and $3,200 for a couple. There is no additional asset disregard. 2) Asset Spend Down – Seniors who have assets over Medicaid's limit can still become asset-eligible by spending down extra assets on non-countable ones.

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 does Medicaid cover for seniors?

Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services including prescription drugs, case management, physical therapy, and occupational therapy.

Do I need to notify Social Security when I turn 65?

You don't need to notify Social Security that you're turning 65. Instead, you apply for Social Security when you want your benefits to start, which could be as early as age 62 or as late as age 70.

Is Medicare free at age 65?

Medicare Part A (hospital insurance)

You're eligible for Part A at no cost at age 65 if 1 of the following applies: • You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB).

How much Social Security will I get at age 65?

If you start collecting your benefits at age 65 you could receive approximately $33,773 per year or $2,814 per month.

What age do I lose my Medicaid?

Young people up to 21 may be eligible for Medicaid. Youth who have "aged out" of foster care can be covered under Medicaid until they reach 26; there is no income limit for these youth. Medicaid and CHIP coverage is for U.S. citizens and certain lawfully present immigrants.

Who is not eligible for Medicare at age 65?

Medicare Part A Based on Age for People Who Must Pay a Premium. People who must pay a premium for Part A do not automatically get Medicare when they turn 65.

What is the best health insurance for seniors on Medicare?

Best Medicare Supplement: AARP/UnitedHealthcare. AARP/UnitedHealthcare is the best company for Medigap plans in 2025. For most people, the best company for Medigap coverage is AARP/UnitedHealthcare. Medicare Supplement (Medigap) plans cover many of the costs that you usually pay if you have regular Medicare.

How do I protect my bank account from Medicaid?

One such option to protect assets is a Medicaid Trust. By placing some of your assets in an appropriate trust, you can protect them from Medicaid and have them not be counted when you are applying for benefits.

Does Medicaid track your income?

Some states use a computerized system to cross reference a Medicaid applicant's reported income. For instance, in California, an electronic database, the Income Eligibility Verification System (IEVS), is used to match the income information provided by the applicant to other databases to verify it is accurate.

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.

What is the Medicaid five year rule?

In most states, the Look-Back Period is five years long. This means the state officials who are reviewing your Medicaid application will “look back” into your financial history for the five years before you applied to make sure you haven't given away any money or assets, or sold them at less than fair market value.

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.

Can Medicaid garnish your Social Security check?

If you have debt from a credit card, payday loan, auto loan, medical bill or personal loan, commercial creditors are not allowed to access your federal benefits, including Social Security. And that's even if you have payments that are overdue.

What happens to your money when you go to a nursing home?

The basic rule is that all your monthly income goes to the nursing home, and Medicaid then pays the nursing home the difference between your monthly income, and the amount that the nursing home is allowed under its Medicaid contract.

Who qualifies for an extra $144 added to their Social Security?

To qualify to get $144 added back to your Social Security check, you can enroll in a Medicare Advantage plan that offers a Part B premium reduction or giveback benefit.