How Medicare and Ohio Medicaid work together
Medicare is federal health insurance based on age, disability or kidney failure. Ohio Medicaid, run by the Ohio Department of Medicaid, is based on income and resources. When you have both:
- Medicare pays first for hospital, doctor and drug costs.
- Medicaid pays second for Medicare costs it covers and for services Medicare doesn't, such as long-term nursing home care and home care waivers.
- Your drugs come from Medicare Part D, with Extra Help applied automatically (42 CFR 423.773(c)).
Full Medicaid or help with Medicare costs only
| Type | What Medicaid does |
|---|---|
| Full Medicaid | Pays after Medicare, covers long-term care, and is delivered through a MyCare Ohio plan for most people 21+ |
| QMB | Pays Part A and Part B premiums, deductibles and coinsurance; providers can't bill you for Medicare cost sharing |
| SLMB or QI | Pays the Part B premium |
Ohio calls QMB, SLMB and QI the Medicare Premium Assistance Program (OAC 5160:1-3-02.1). In 2026, QMB is for single people with monthly income up to $1,350 and resources up to $9,950. See Medicare Savings Programs in Ohio.
Where MyCare Ohio fits
Since August 1, 2026, Next Generation MyCare Ohio has covered all 88 counties. If you have full Medicaid and Medicare Parts A, B and D and are 21 or older, you are enrolled in a MyCare plan for Medicaid. For Medicare you choose: the same MyCare plan for both, or Original Medicare or another Medicare plan. See MyCare Ohio.
How to apply
Apply at benefits.ohio.gov or your county Department of Job and Family Services. Plan questions go to the Ohio Medicaid Consumer Hotline at 1-800-324-8680. To review Medicare plan options from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
What is the difference between Medicare and Medicaid in Ohio?
Who runs each and who qualifies.
What is MyCare Ohio?
Ohio's plan for people with both.
What is a D-SNP in Ohio?
Medicare Advantage for dual eligibles.
Sources
- Medicare.gov — Medicaid
- Ohio Administrative Code — Rule 5160-58-02, MyCare Ohio eligibility
- Ohio Administrative Code — Rule 5160:1-3-02.1, Medicare premium assistance programs
- Medicare.gov — Medicare Savings Programs
More questions in this guide
- Does Ohio Medicaid pay for nursing home care?
- Does Ohio Medicaid take your house after you die?
- Is MyCare Ohio available in my county?
- What is the difference between Medicare and Medicaid in Ohio?
- What is a dual eligible special needs plan in Ohio?
- What is a qualified income trust (Miller trust) in Ohio?
- What is MyCare Ohio?
- What is Next Generation MyCare Ohio?
- What is the PASSPORT waiver in Ohio?
Part of the guide: Ohio Medicaid and Medicare together · All questions
Frequently asked questions
Do I lose Ohio Medicaid when I get Medicare?
Not automatically. Once you have Medicare or turn 65, Ohio reviews your Medicaid under its aged, blind and disabled rules, which count income and resources. Answer every renewal letter from your county Job and Family Services office.
Does Medicaid pay my Medicare Part B premium?
Usually, yes. Full Medicaid members and people in a Medicare Savings Program (QMB, SLMB or QI) have their Part B premium, $202.90 a month in 2026, paid by Ohio Medicaid.
Who covers my prescriptions if I have both?
Medicare Part D. With Medicaid you get Extra Help automatically, which lowers Part D costs, and you can switch Part D plans once a month.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
