Medicare is a federal health program for people over 65, people under 65 with a disability or people of any age who have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Medicaid is a state-run health program for low-income people who may also belong to a specific group, such as pregnant people, people with disabilities and older adults. 

Medicaid programs vary from state to state; your state may offer multiple Medicaid plan options, each with their own fine print. 

Full dual eligibility means that you qualify for full Medicaid and Medicare, with Medicaid helping you cover your Medicare costs. Partial dual eligibility means that you get full Medicare benefits, with Medicaid covering some of your Medicare costs.

There are many ways you can become dually eligible. Generally speaking, though, you qualify for Medicare by turning 65 and/or having a disability before age 65, while Medicaid eligibility depends on your income (the limit varies by state).

In addition to Medicare and Medicaid, supplements like the Medicare Savings Program and the Medicare Extra Help program can provide additional financial assistance. There is also the Ryan White CARE Act (RWCA) as a payer of last resort for expenses (such as dental) that neither Medicare nor Medicaid covers.

To enroll in whichever program for which you are eligible, ask your local HIV and AIDS service organization or Ryan White administrative office whether they have a case manager you can work with. Applying is often far too complex to do on your own. If you’re eligible for Medicare- or think you might be, you can also call a State Health Insurance Assistance Programs counselor at (877) 839-2675  or use this locator tool for free help.