Birthday celebrations are a big deal, especially those milestone birthdays. It’s just as important to celebrate 65 as it is to celebrate 18. Both are significant years that usher in a lot of changes. When you turn 65, it’s time to revisit your health insurance options – you can now enroll in Medicare. But what if you already have Medicaid (called Medical Assistance in Minnesota)? Here’s what you need to know, including next steps and reviewing insurance options.

Next steps for getting Medicaid coverage at age 65

Once you turn 65 (or under 65 for people with specific disabilities), you may become eligible for Medicare – it’s time to choose a Medicare plan! Does that mean you have to stop your Medicaid coverage to enroll? Not necessarily. Medicaid covers important services that meet your health needs as you get older. In addition to medical, dental and prescription drug coverage, it also includes long-term care and home- and community-based services. Why lose that if you don’t have to?

The good news is that you may be able to have both if you’re eligible for Medicare and Medicaid. That’s why this period is a critical time to review your options. A dual eligible plan is a great choice for those with limited income who need more coverage.

However, Medicaid eligibility is different from state to state. In Minnesota, your local county will determine if you can enroll based on your situation.

Sign up for Medicare

Since you can have Medical Assistance and Medicare at the same time, it’s a good idea to sign up for Medicare as soon as you’re eligible. If you’re getting Social Security benefits, the Social Security Administration (SSA) will automatically sign you up for Medicare Parts A and B. If you aren’t getting Social Security, you’ll need to apply for Medicare through the SSA.

Need a refresher on Social Security and Medicare? Learn how Medicare and Social Security are different – and how they can work together.

Transition from Medicaid to Medicare – or to one plan that combines both programs

Once you turn 65, you become eligible for Medicare coverage. However, during this time, your eligibility for Medicaid can also change. But why is this? Under the Affordable Care Act (ACA), most state Medicaid programs expanded health coverage for Americans under the age of 65. So if you once qualified for Medicaid as part of this Medicaid expansion group, you may no longer be eligible once you hit your 65th birthday.

However, it’s important to keep in mind that state requirements can vary. If you meet a certain income requirement, your eligibility for Medicaid can be re-evaluated before your 65th birthday to see if you qualify for another Medicaid eligibility group. If you continue to be eligible for Medicaid once you turn 65 and also qualify for Medicare, you’ll be considered dual eligible for both Medicare and Medicaid.

Being dual eligible is great for those who need extra assistance. Medicaid may offer coverage for services that Medicare doesn’t, such as longer-term nursing facility care, prescription drugs, eye care, vision care and more. But what happens if you aren’t eligible for Medicaid and still need that extra help? Some seniors may qualify for their state’s Medicare Savings Program. These programs can help those on Medicare pay premiums or out-of-pocket costs.

Review Medicare and Medicaid options in your county

Different health plans are available based on where you live. If you already have Medicaid, you’ve most likely been in touch with a county worker who has helped you with your plan. As you approach your 65th birthday, your county worker will automatically enroll you in a new Medicaid plan.

Your options at age 65 as a Minnesota resident include the Medicaid-only plan called Minnesota Senior Care Plus (MSC+) or the Medicare and Medicaid plan called Minnesota Senior Health Options (MSHO).

Work with a long-term care social worker

If you are in a nursing home or assisted living, the facility’s social worker can help you and your family complete the steps to get the right plan. The social worker is a helpful resource between you and the county worker.

Get more info on Medicaid eligibility after age 65

If you think you’re eligible for an MSC+ or MSHO plan, you can get information from: