Fair Square Medicare Wordmark

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

A person with a shopping cart already containing medicaid and medicare sees Medigap options on a table. In a thought bubble, they ask "Should I get Medigap too?"
By Daniel Petkevich
Jan 7, 2023

You may enroll in more than one plan, but you don't need all three. Here's why:

Medicare, Medicaid, and Medigap (also known as Medicare Supplement) often overlap; sometimes, people sign up for more than one plan. But is there ever a time when you should enroll in all three?

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.
We want you to get the best benefits possible, so we'll walk you through everything you need to know.
Let's explore Medicare, Medicaid, and Medigap in more detail, get a sense of their differences, and discuss whether to enroll in more than one plan.

What's the Difference Between Medicare, Medicaid and Medigap?

Medicare, Medicaid and Medigap all assist in covering your healthcare expenses. But they help different populations and meet unique needs.
Let's take a look at each plan.


It provides coverage to people ages 65+ and those with disabilities or


(end-stage renal disease).
There are four parts to Medicare:
  • Part A — part of Original Medicare; covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare
  • Part B — part of Original Medicare; covers medically necessary services and preventive care, such as doctor visits, lab tests, and durable medical equipment
  • Part C (Medicare Advantage) — alternative to Parts A and B offered by private insurance companies; combines all the benefits of Parts A and B and often includes additional benefits, such as prescription drug coverage
  • Part D — prescription drug benefit that can be added to Original Medicare (Parts A and B) or a Part C plan


Medicaid is a joint federal and state program that provides health insurance to low-income individuals and families — including the elderly, individuals with disabilities, children, and pregnant women.
Medicaid might cover a wide range of medical services, such as:
  • Doctor visits
  • Hospital stays
  • Prescription drugs
  • Long-term care
  • Immunizations
  • Screenings
Medicaid is administered by the states (rather than at a federal level). And each state has its own eligibility criteria and benefits. To be eligible for Medicaid, you must meet your state's income and asset requirements.


Medigap is a supplemental insurance policy that supplements Original Medicare (Part A and Part B).
It helps cover certain out-of-pocket costs — like copayments, coinsurance, and deductibles. However, it doesn't cover

long-term care

, vision, dental, hearing aids, private-duty nursing, and prescription drugs.
Medigap policies are offered by private insurance companies and are standardized by the federal government. You can choose from

10 Medigap plans

depending on your requirements.

Medicare Supplement Plan G

offers the most comprehensive coverage for many of our clients.

Can I Get Both Medicare and Medicaid Benefits Together?

Yes. You can benefit from Medicare and Medicaid if you're dually eligible. In other words, you have to meet the eligibility requirements for both Medicare and Medicaid.
To be dually eligible, you must meet the following conditions:
  • Be 65 years or older or have a disability (like ESRD)
  • Have a low income

How Do Medicare and Medicaid Work Together?

Medicare covers 80% of your healthcare expenses, while Medicaid helps cover the remaining out-of-pocket costs left by Medicare Parts A and B.
In other words, Medicare covers services that Medicaid doesn't and vice versa.
For example, Medicare may cover your hospital stays, doctor visits, and lab tests, while Medicaid covers your additional expenses like premiums, prescription drugs, eyeglasses,

hearing aids

and long-term care. Both work together to maximize your benefits and provide comprehensive coverage.
To better understand how these two programs work together, you need to be familiar with two terms: coordination of benefits and crossover claims.

What Is Coordination of Benefits?

When a person has multiple health insurance plans (like Medicare and Medicaid), providers must coordinate their benefits to avoid overpaying or duplicating coverage. Coordination of benefits determines which health insurance plan should pay for a medical service or claim first.
  • "Primary" payer — the insurance plan that pays first
  • "Secondary" payer — the plan that pays second
In general, Medicare is the primary payer, and Medicaid is the secondary payer. This means Medicare will pay for covered medical services first, and Medicaid will pay for any remaining expenses not covered by Medicare — like copayments, deductibles and coinsurance.

What's a Crossover Claim?

A crossover claim is a medical claim submitted to multiple insurance plans. They're used when an individual has two insurance plans that coordinate their benefits.
For example, if you’re enrolled in both Medicare and Medicaid, your provider will submit the claim to Medicare. Medicare will process the claim first and apply any deductibles, coinsurance, or copayments. The claim will then be automatically forwarded to Medicaid. (Note: Your provider doesn't have to bill Medicaid separately for the deductible, coinsurance, or copayments that Medicare applied).

Is Medigap Necessary If You Are Eligible for Both Medicare and Medicaid?

No. You don't need to enroll in a Medigap Plan if you're enrolled in Medicare and are eligible for full Medicaid benefits.
Here's why:
  • Most of your medical expenses are likely covered if you're dually eligible for Medicare and Medicaid
  • Insurance companies aren't permitted to sell Medigap policies to Medicare beneficiaries with full Medicaid coverage

I Don't Qualify for Medicaid. Can I Still Get a Medigap Plan?

Yes! Medigap plans are good for individuals who don't qualify for Medicaid. They're especially helpful if you have a high income or assets and need help with out-of-pocket costs not covered by Original Medicare (Parts A and B).


Medicare, Medicaid, and Medigap are all health insurance programs that cover your medical expenses. Medicaid is specifically designed to help low-income individuals pay for out-of-pocket costs. In contrast, Medigap plans often help high-income individuals — who aren't eligible for Medicaid — pay for their out-of-pocket costs.
You don't need to enroll in a Medigap Plan if you're eligible for both Medicare and Medicaid. Medicaid will likely cover most of your out-of-pocket expenses.
Having multiple health insurance plans can give you more comprehensive coverage. But it can also be confusing. At

Fair Square Medicare

, we have helped thousands of beneficiaries understand the ins and outs of Medicare and make informed decisions about their coverage. If you have any questions, give us a call at 1-888-376-2028.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

senior gentleman wearing a suit working on his laptop outside of his office stock photo
How Your Employer Insurance and Medicare Work Together
Sep 27, 2022
breast cancer awareness ribbon stock image
Does Medicare Cover Piqray?
Dec 2, 2022
Doctor demonstrating upper cervical spine anatomy stock photo
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
Philadelphia skyline at sunset stock image
13 Best Ways for Seniors to Stay Active in Philadelphia
Mar 7, 2023
bearded man holding his head in confusion looking at his laptop stock image
Why Is Medicare So Confusing?
Apr 19, 2023
An elderly couple discusses their healthcare and insurance needs with another woman stock image
Medicare Guaranteed Issue Rights by State
Feb 10, 2023
air purifier stock image
Does Medicare Cover Air Purifiers?
Nov 18, 2022
Medicare Enrollment Periods stock image
Explaining the Different Enrollment Periods for Medicare
Feb 3, 2023
20 Q's with Fair Square
20 Questions to Ask Your Medicare Agent
Mar 17, 2023
Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo
Is Emsella Covered by Medicare?
Nov 21, 2022
Cover image
When to Choose Medicare Advantage over Medicare Supplement
Jun 7, 2023
Illustrated representation of medical marijuana, using a prescription bottle with a marijuana leaf on the front.
Does Medicare Cover Medical Marijuana?
Jan 6, 2023
Medicare Set Aside funds stock image
What Happens to Unused Medicare Set-Aside Funds?
Jan 20, 2023
surgeons working over a patient stock image
Does Medicare Cover LVAD Surgery?
Nov 30, 2022
Senior woman smiling after vaccination stock photo
Does Medicare Cover Flu Shots?
Dec 9, 2022
Medicare cost stock image
How Much Does Medicare Cost?
Jul 25, 2022
woman sitting up in bed experiencing back pain stock photo
Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022
Doctor physician consulting with male patient in hospital exam room stock photo
Is Gainswave Covered by Medicare?
Dec 6, 2022

More of our articles

14 Best Ways for Seniors to Stay Active in Nashville

2023 Medicare Annual Election Period (AEP)

Can Doctors Choose Not to Accept Medicare?

Can I switch From Medicare Advantage to Medigap?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Do All Hospitals Accept Medicare Advantage Plans?

Do I Need Medicare If My Spouse Has Insurance?

Do Medicare Supplement Plans Cover Dental and Vision?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover Abortion Services?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cartiva Implants?

Does Medicare cover Deviated Septum Surgery?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Ilumya?

Does Medicare Cover INR Machines?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Jakafi?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Lipoma Removal?

Does Medicare Cover Macular Degeneration?

Does Medicare Cover Nuedexta?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Oxybutynin?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Scleral Lenses?

Does Medicare Cover Service Animals?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover SIBO Testing?

Does Medicare Cover Tymlos?

Does Medicare Cover Vitamins?

Does Medicare Cover Wart Removal?

Does Medicare Cover Zilretta?

Does Medicare Pay for Allergy Shots?

Does Medicare Pay for Varicose Vein Treatment?

Estimating Prescription Drug Costs

Explaining IRMAA on Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

How Does Medicare Cover Colonoscopies?

How Does Medicare Pay for Emergency Room Visits?

How Medicare Costs Can Pile Up

How Much Does Medicare Part A Cost in 2023?

How Much Does Trelegy Cost with Medicare?

How to Become a Medicare Agent

How to Deduct Medicare Expenses from Your Taxes

Is Botox Covered by Medicare?

Is Displacement Affecting Your Medicare Coverage?

Is HIFU Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare Consulting Services

Medicare Explained

Medicare Supplement Plans for Low-Income Seniors

Plan G vs. Plan N

Should You Work With A Remote Medicare Agent?

The Easiest Call You'll Ever Make

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: June 2023

Welcome to Fair Square's First Newsletter

What Are Medicare Part B Excess Charges?

What Does Medicare Cover for Stroke Patients?

What is a Medicare Beneficiary Ombudsman?

What is the Medicare ICEP?

What's the Deal with Flex Cards?

When Can You Change Medicare Supplement Plans?

Why You Should Keep Your Medigap Plan

Will Medicare Cover Dental Implants?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.


Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.