I’ve received SSI and Medicaid for about 30 years but didn’t qualify for Medicare because I lacked enough work credits. When I turn 65, will I be eligible for both Medicare and Medicaid?

Question

Juan Carlos Quevedo Lussón · Accepted Answer

You may be eligible for both at 65. Not having enough work credits does not necessarily prevent you from getting Medicare—it usually affects whether Part A is premium-free. SSI alone does not qualify you for Medicare, even after many years of receiving it. ssa.gov

Here’s how it can work:
- Medicare eligibility: At 65, you can generally enroll if you meet the citizenship and residency requirements. Part B does not require work credits. If you cannot get premium-free Part A through your own or a qualifying spouse’s work record, premium Part A may be available. ssa.gov
- Help paying premiums: Your state may cover the Part A and Part B premiums through the Qualified Medicare Beneficiary (QMB) program. QMB also protects you from being billed Medicare deductibles, coinsurance, and copayments for covered services. Eligibility must be confirmed by your state.
- Keeping Medicaid: Getting Medicare does not automatically end Medicaid. If you continue meeting your state’s Medicaid requirements, you can have both. Medicare generally pays first for Medicare-covered services. Medicare
Start about three months before your 65th birthday. Contact Social Security and your Medicaid office and say:
“I receive SSI and Medicaid but don’t have enough work credits for premium-free Part A. Please check my Medicare eligibility and whether I qualify for QMB or state payment of my Part A and Part B premiums.”

Ask whether you need conditional Part A enrollment, which ties enrollment to approval of state premium assistance. The process varies by state, so don’t assume SSI means everything will happen automatically.

Michelle Sparks · Answer

You can get both. At age 65, you qualify for Medicare even without work credits, and you can keep Medicaid if you continue to meet your state's financial limits.

Here is the quick breakdown of how they work together and what they cost:

• Medicare Eligibility & 2026 Costs: You can enroll at 65, but because you lack work credits, your Part A will have a premium of up to $565 per month. Your Part B premium will be the standard $202.90 per month.
• 2026 Deductibles: The Part A hospital deductible is $1,736 per benefit period, and the Part B annual outpatient deductible is $283 per year.
• Medicaid Transition: Turning 65 triggers a routine state review to switch your Medicaid category from "disability-based" to "aged-based" (for seniors 65+).
• State Help to Eliminate Costs: If your income and assets remain low, you will become dually eligible. A state Medicare Savings Program (MSP) could step in to pay your $565 Part A premium, $202.90 Part B premium, and all deductibles, bringing your out-of-pocket medical costs down to $0. You may also automatically get Extra Help to cap prescription co-pays at just a few dollars.

An experienced Medicare broker can help you navigate this transition and ensure you don’t miss out on benefits or miss enrollment deadlines.

Nicoletta Catalucci · Answer

Yes, you may be eligible for both Medicare and Medicaid when you turn 65, even if you don't have enough work credits. The important thing to understand is that work credits mainly determine whether you qualify for Medicare Part A without paying a monthly premium.

Since you already receive SSI and Medicaid, your state may be able to help pay your Medicare premiums through a Medicare Savings Program. You may also be able to keep Medicaid as long as you continue to meet your state's eligibility requirements. I would recommend checking with Social Security and your state's Medicaid office before your 65th birthday so you know exactly what coverage and financial assistance you qualify for.

Serlet Reyes · Answer

Yes, in most cases you can get both. Even without enough work credits you can still get Medicare at 65, and because you have Medicaid, your state usually pays your Part A and Part B premiums. You'd also get Extra Help with your prescriptions automatically. Call your local Medicaid office or Social Security a few months before your birthday to make sure you get enrolled on time.

Answered by Serlet Reyes on October 27, 2026

Broker Licensed in FL, AL, AZ & 17 other states

Answered by Serlet Reyes Medicare Insurance Agent

Justine Rojas · Answer

You may qualify for both Medicare and Medicaid when you turn 65, even if you do not have have enough work credits. That said, you may have to pay a premium for Medicare Part A, but if you qualify for Medicaid, your state may help cover the Medicare premiums.

Answered by Justine Rojas on October 27, 2026

Broker Licensed in GA, AL, FL & 5 other states

Answered by Justine Rojas Medicare Insurance Agent

Danielle Rose · Answer

You will most likely be automatically enrolled into Medicare Parts A and B, but you may need to reapply with your state to maintain your Medicaid status.

Arnett Evans · Answer

Generally you should qualify once you reach age 65, but in order to understand your personal situation, you would have to contact your local Social Security Office to understand all the options available to you.

Answered by Arnett Evans on October 26, 2026

Broker Licensed in MS, FL, ME, MI, TN & TX

Answered by Arnett Evans Medicare Insurance Agent

Mike Alexander · Answer

You can go to medicare.gov and applyyou have paid in by your ssi income so you can apply for medicare do it now

I’ve received SSI and Medicaid for about 30 years but didn’t qualify for Medicare because I lacked enough work credits. When I turn 65, will I be eligible for both Medicare and Medicaid?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

I’ve received SSI and Medicaid for about 30 years but didn’t qualify for Medicare because I lacked enough work credits. When I turn 65, will I be eligible for both Medicare and Medicaid?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website