Can you have both Medigap and Medicaid? This is a common and important question for Medicare beneficiaries with limited income seeking full coverage without paying extra out-of-pocket. While both programs offer different forms of financial relief, having both at the same time is not always allowed—or even necessary.
Skyline Benefit, a trusted Medicare insurance broker in California, explains how Medigap and Medicaid work, whether they can be combined, and how to determine the right path for your specific healthcare and financial situation.
What Is Medigap and What Does It Cover?
Medigap, also known as Medicare Supplement Insurance, helps cover costs not paid by Original Medicare, such as deductibles, copayments, and coinsurance. Private insurance companies sell it, and it is only available to individuals enrolled in both Medicare Part A and Part B.
Medicare Supplement Insurance is designed for people who do not have other assistance like Medicaid. If you’re paying for a Medigap plan and later become eligible for Medicaid, you may no longer need it.
What Does Medicaid Cover for Medicare Beneficiaries?
Medicaid offers financial assistance to individuals with limited income and resources. For those who qualify for both Medicare and Medicaid (also called dual-eligible individuals), Medicaid can cover:
- Medicare Part A and Part B premiums
- Deductibles and copayments
- Prescription drug costs through the Extra Help program
- Some services Medicare does not cover, such as long-term care in certain facilities
If you have Medicaid, you may not need any additional Medicare Supplement plan because Medicaid often pays for what Medigap is intended to cover.
Can You Have Both Medigap and Medicaid?
In most cases, you cannot and should not have both Medicare Supplement Insurance and Medicaid.
You cannot purchase a Medigap plan if you qualify for full Medicaid. If you already have a Medigap plan and later qualify for Medicaid, dropping your Medigap coverage is usually recommended.
However, some individuals may qualify for partial Medicaid programs (such as QMB or SLMB). In these cases, a Medigap plan might still be allowed, depending on your situation and needs. But it’s not always cost-effective.
What Happens If You Already Have Both?
You may be overpaying for unnecessary coverage if you’re enrolled in Medigap and Medicaid. Most insurance companies will cancel your Medigap policy if you qualify for full Medicaid, as the two programs are not meant to work together.
Always notify your Medigap insurer if your Medicaid status changes so you’re not paying premiums for coverage you don’t need.
Should You Choose Medigap or Medicaid?
Here’s what to consider:
- You typically do not need a Medigap plan if you qualify for full Medicaid. Medicaid already covers most costs.
- If you only qualify for partial Medicaid, such as assistance with premiums, a Medicare Supplement Insurance plan might make sense depending on your health needs and financial situation.
- If you’re at risk of losing Medicaid, Medicare Supplement Insurance could be a good backup option to avoid coverage gaps.
Before choosing either plan, evaluating your eligibility and future coverage needs is best.
Do You Need Medicare Supplement Insurance If You Have Medicaid?
In most situations, no. Medicaid is meant to fill the gaps left by Medicare. Medigap is also meant to do the same but involves paying a monthly premium.
Having both often results in duplicate coverage and unnecessary costs. That’s why most beneficiaries who qualify for Medicaid drop their Medigap plans to avoid paying for coverage they don’t need.
Need Help Understanding If You Can Have Both Medigap and Medicaid?
Skyline Benefit is an independent Medicare insurance broker that offers affordable and flexible Medigap options. Selecting the best Medicare plan in 2025 can be overwhelming; our mission is to simplify the process and help our clients every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112