Income limits for dual enrollment in Medicaid and Medicare depend on how you qualify. General Medicaid income limits vary by state, but federal Medicare savings program limits can also qualify you for both programs.
If you’re eligible for both Medicare and Medicaid, you’re known as a dual eligible beneficiary. In this case, you may be one of 12 million people, or about 3% of the United States population, enrolled in Medicare and Medicaid.
Dual eligibility usually depends on your age, any disabilities you might be living with, and your income. This article discusses the dual eligible Medicare and Medicaid income limits for 2025 and what you need to know if you think you may qualify for both programs.
You may be entitled to enroll in Original Medicare (Part A and Part B) and Medicaid if you’re 65 years old or older (or if you’re younger than that but have qualifying disabilities) and you’re below the income threshold for general Medicaid qualification.
The income limits for Medicaid are generally based on the federal poverty level (FPL) but vary by state and eligibility group. Most people qualify if they earn less than 133% of the FPL, but some groups, such as children qualifying for the Children’s Health Insurance Program (CHIP), may be eligible if their parents earn up to 375% of the FPL in some states.
Additional income limits
There are also several other ways to qualify for dual eligibility that involve income limits. Generally, this happens through one of the following Medicare savings programs (MSPs):
The table below summarizes the income limits for qualifying for these different MSPs in 2025:
| MSP | Eligibility |
|---|---|
| QDWI | Individual • Income: $5,302 • Assets: $4,000 Married • Income: $7,135 • Assets: $6,000 |
| QI | Individual • Income: $1,781 • Assets: $9,660 Married • Income: $2,400 • Assets: $14,470 |
| QMB | Individual • Income: $1,325 or less • Assets: $9,660 Married • Income: $1,783 or less • Assets: $14,470 |
| SLMB | Individual • Income: $1,585 • Assets: $9,660 Married • Income: $2,135 • Assets: $14,470 |
People may often confuse Medicare and Medicaid because both are government healthcare programs. Medicare, which is funded by the government, serves mainly older Americans and those with certain disabilities. Medicaid is a state and federal collaboration program that helps low income households with their healthcare costs.
So, in summary, while Medicare eligibility is mainly based on age and disability, Medicaid eligibility is based on income. This means that typically, people who are dually eligible for both programs might be adults 65 years old or older who are generally healthy but have limited finances.
Alternatively, they can be people living with disabilities who face challenges in finding and keeping jobs, as well as people under 65 years old who stopped working because of a significant physical or mental disability.
It’s important to understand that if you’re dually eligible, your Medicare plan will usually cover your healthcare costs first, and Medicaid will step in to help with costs that Medicare might not fully cover, such as home-based services, personal care, and nursing home care.
How do I know if I am dually eligible for Medicare and Medicaid?
To be dually eligible, you generally have to qualify for or enroll in both Medicare or Medicaid based on each program’s individual eligibility criteria or because you are enrolled in a qualifying MSP.
To find out whether you’re eligible for both programs and to learn how to enroll, you can apply for Medicare online and apply for Medicaid on the website of your state’s agency for Medicaid.
If you qualify for Medicare and Medicaid, you’re referred to as a dual eligible beneficiary. Dual eligibility is typically determined by factors such as your age, any disabilities you may have, and your income level.
The income criteria for dual enrollment in Medicaid and Medicare vary based on how you qualify for both programs. While Medicaid’s general income limits differ from state to state, the federal Medicare savings program limits can enable you to qualify for both programs.