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Do You Need Medicare Part B to Get Medicaid?

You aren't required to have Medicare Part B to get Medicaid. The reason is that Medicare and Medicaid are entirely separate programs with very different qualification criteria. Medicare covers all U.S. citizens and legal residents over age 65, regardless of their incomes or net worth. Medicaid is designed to cover the needy and indigent of all ages.

  1. Medicare

    • Medicare consists of four basic parts: Part A covers basic hospitalization costs. There is no premium for Part A and seniors are automatically enrolled when they turn 65 or when they apply for Social Security benefits. Part B covers physicians' charges, durable medical equipment and diagnostic and lab fees. Part C, Medicare Advantage, is a way for seniors to access their benefits via private managed-care organizations. Part D covers prescription drugs. Part B, C and D each require premiums and are optional, though seniors are automatically enrolled in Part B and have to opt out when they become eligible for benefits, if they don't wish to participate.

    Medicaid

    • Medicaid is a state-administered program that provides basic medical services to those with limited incomes and low net worth. Unlike Medicare, which has an age requirement, Medicaid allows people to qualify for coverage at any age. Each state has different eligibility criteria. However, in no case is participation in Medicare Part B a requirement to qualify for Medicaid.

    Medicaid Eligibility

    • Under federal Medicaid rules, states must offer eligibility to families of very low incomes at or near the federal poverty line, to infants whose mothers are covered by Medicaid, and to certain categories of the handicapped, such as the blind and people who receive disability, or SSI benefits, from the Social Security Administration.

    Enrollment

    • No single nationwide portal for Medicaid enrollment exists. Each state maintains its own separate enrollment administration. States may also expand eligibility to other individuals beyond those required to be granted eligibility under Medicaid eligibility rules.

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