Medicare and Medicaid Eligibility Check
Answer a few simple questions to identify possible Medicare, Medicaid, Medicare Savings Program, dual-eligibility, and long-term-care paths—then verify or apply with the official agency.
Not an official determination
This tool identifies paths worth checking. Medicare, Social Security, and the state Medicaid agency decide eligibility.
Rules change
Numeric federal rules shown here are dated and sourced. State rules can change at any time. Last reviewed July 10, 2026.
Answers stay on this device
Answers remain in local React state. This page does not submit or store age, income, disability, pregnancy, household, or care information.
Choose the closest answer. Use Not sure rather than guessing.
What state does the person live in?
Medicaid rules and application systems are state-specific.
Four different questions—not one universal cutoff
Medicare, ordinary Medicaid, long-term-care Medicaid, and Medicare cost assistance use different legal pathways. This tool keeps them separate.
Medicare paths
Age 65 is one path, but disability benefit entitlement, ALS, and end-stage renal disease can create separate paths before 65.
Medicaid categories
States assess categories such as adults, pregnancy, children, disability, older adults, and medically needy pathways under different rules.
Long-term-care Medicaid
Nursing-home and long-term services screening can involve functional need, income, assets, transfers, and spousal protections—not just ordinary coverage income.
Dual and cost help
A person with Medicare may also qualify for full Medicaid or a Medicare Savings Program that helps with Medicare costs.
Dated rules are centralized and visible
The screen uses age 65 and the 24-month SSDI Medicare timing rule as federal routing signals. For Medicare Savings Programs, it can compare entered income with 2026 federal QMB, SLMB, and QI screening amounts. A state may use more generous rules or count income and resources differently.
| 2026 federal MSP screen | Individual monthly income | Married-couple monthly income |
|---|---|---|
| QMB | $1,350 | $1,824 |
| SLMB | $1,616 | $2,184 |
| QI | $1,816 | $2,455 |
Why the result stays qualified
- • Medicaid categories can use different household, income, resource, and medical-need rules.
- • The state may disregard some income or use limits above the federal amount.
- • Medicare eligibility and premium-free Part A are not the same determination.
- • Long-term-care Medicaid should not be reduced to a health-coverage income screen.
Use the result with the right guide
These pages explain the coverage and care-planning distinctions that commonly change the next step.
Medicare vs. Medicaid
Understand why the programs overlap but use different eligibility and coverage rules.
Open guideMedicare, Medicaid & long-term care
Review coverage gaps, cost exposure, skilled care, and custodial care planning.
Open guideHospital discharge and long-term care guide
Prepare for rehab, home health, equipment, Medicaid, and post-hospital care decisions.
Open guidePrimary sources and review dates
Eligibility logic uses only Medicare.gov, SSA.gov, Medicaid.gov, CMS/HHS, and official state agencies.