Frequently Asked Questions
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Who does Medicare Cover?
Who does Medicare Cover?
Medicare generally covers people age 65 and older and some younger individuals with disabilities or end-stage renal disease. For details, please visit the “Medicare & Medicaid Facts” page.
Who does Medicaid Cover?
Who does Medicaid Cover?
Medicaid generally covers low-income individuals and families, including children, pregnant women, seniors, and people with disabilities. For details, please visit the “Medicare & Medicaid Facts” page.
How do I know if I'm eligible for Medicare, Medicaid, or both?
How do I know if I'm eligible for Medicare, Medicaid, or both?
Eligibility depends on age, income, disability, status, and other factors. For details, please visit the “Medicare & Medicaid Facts” page for information on “Eligibility.”
How do I apply for Medicaid/Medicare in my state?
How do I apply for Medicaid/Medicare in my state?
For Medicare, please use this website. For Medicaid, please apply through your state’s Medicaid office or HealthCare.gov.
Do immigrants or green card holders qualify for Medicaid?
Do immigrants or green card holders qualify for Medicaid?
Some lawful permanent residents qualify after a 5-year waiting period, though rules vary by state.
What should I do if I receive a confusing or unexpected medical bill?
What should I do if I receive a confusing or unexpected medical bill?
Compare it to your coverage and contact your provider or insurer. You can also request a detailed explanation or file a billing dispute.
How often do I need to reapply or update my Medicaid eligibility?
How often do I need to reapply or update my Medicaid eligibility?
Most states require renewal every 12 months, but you must report changes in income or household right away. Eligibility checks will change to every 6 months starting January 2027.
Where can I get help if I'm denied coverage or can't afford my medical bills?
Where can I get help if I'm denied coverage or can't afford my medical bills?
Contact your state Medicaid office, a legal aid group, or a health advocate. Many nonprofits also offer support. For details, please visit the “What To Do If You're About to Lose Coverage” page.
How do I check if my doctor or hospital accepts Medicaid or Medicare?
How do I check if my doctor or hospital accepts Medicaid or Medicare?
Ask your provider directly, or check the official Medicare or state Medicaid directories online.
Will I still need to pay out-of-pocket costs with Medicare or Medicaid under OBBBA?
Will I still need to pay out-of-pocket costs with Medicare or Medicaid under OBBBA?
Yes. Some co-pays and costs may still apply depending on your coverage. The law simplifies billing but doesn’t eliminate all patient costs. To learn more about OBBBA, please visit the “OBBBA Facts” page.
How often does my income need to be reviewed for Medicaid?
How often does my income need to be reviewed for Medicaid?
Your income is typically reviewed annually, but you must report any significant changes as soon as they happen.
What happens if I don't meet Medicaid's new work requirement?
What happens if I don't meet Medicaid's new work requirement?
You could lose coverage if you don’t meet reporting or work requirements, depending on your state.
How will the OBBBA affect rural hospitals and clinics?
How will the OBBBA affect rural hospitals and clinics?
Critics warn that OBBBA’s Medicaid cuts could reduce funding for rural providers, threatening access to care in those areas. To learn more about OBBBA, please visit the “OBBBA Facts” page.
Can I have private insurance and Medicaid or Medicare at the same time?
Can I have private insurance and Medicaid or Medicare at the same time?
Yes, this is called “dual coverage.” One plan usually acts as the primary payer, and the other as secondary.
How do I avoid losing coverage during re-enrollment or verification checks?
How do I avoid losing coverage during re-enrollment or verification checks?
Respond to renewal notices quickly, update your information regularly, and keep copies of all documents.
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