Turning 65 does not by itself end your Medicaid, but it can close the eligibility group you qualified under and bring a savings test you never faced before.,, If you've been bracing for a cancellation letter and wondering what happens to Medicaid when you turn 65, that worry makes sense. Federal rules require your state to check every other way you might qualify before ending coverage.

In This Guide

Why Turning 65 Matters for Medicaid

Under 42 CFR 435.119, the Medicaid expansion group covers adults 19 to 64 who aren't entitled to or enrolled in Medicare, with income at or below 133% of the federal poverty level (FPL), or 138% after a 5-point disregard. If you qualify for premium-free Part A, it starts the month you turn 65 (the month before, if your birthday falls on the 1st).

Under 42 CFR 435.603(j)(2), people 65 or older leave the MAGI rules only "when age is a condition of eligibility" for the group being tested.

How Medicaid Changes at 65

Expansion adults and caretaker relatives are measured under MAGI rules, and ABD groups use SSI rules., If you've been on expansion Medicaid, your savings have never counted; under an ABD group, they could.,

MAGI groups ABD groups
Who sets the income standard Federal law for expansion adults; the state for caretakers, The state, using SSI methods; one optional group is capped at 100% FPL
2026 yardstick Poverty guideline: $15,960 a year for one person, $21,640 for two SSI federal benefit rate: $994 a month for one person, $1,491 for a couple
Asset test None $2,000 for one person, $3,000 for a couple in countable resources; states may be less strict
Social Security All of it counts, with no $20 exclusion Counted under SSI rules, with the $20 general exclusion

Those 2026 poverty figures cover the 48 contiguous states and DC. The 2026 federal SSI rate is $994 a month for one person; many states add a supplement., Your state sets its actual ABD standard.

Your home, one vehicle used for transportation and household goods don't count toward the 2026 SSI countable-resource limit of $2,000 for one person. See countable vs. exempt assets and how Social Security affects Medicaid.

Which Situation Are You In?

You're on expansion Medicaid

Your 65th birthday closes the Medicaid expansion adult group, which covers only adults under 65. Before ending your coverage, your state must consider every other basis of Medicaid eligibility. An ABD group usually brings an asset test you've never faced, though some states have raised or dropped the limit, so know your countable savings now.

You're a parent or caretaker relative

Evaluated as a parent or caretaker relative, you stay on MAGI rules at 65, with no asset test, if you meet the caretaker definition and your state's income standard. See caretaker-relative Medicaid for grandparents.

You're on SSI or ABD Medicaid

You're already on SSI methods, so the asset test isn't new. ABD renewals come at least every 12 months, and a state may check more often.

You're disabled and already on Medicare

If you have Medicare because of a disability, you aren't in the expansion group, which excludes anyone entitled to or enrolled in Medicare.

When the Change Shows Up

The birthday can surface at your regular 12-month redetermination for MAGI coverage. For most expansion adults, renewals scheduled on or after January 1, 2027 move to every 6 months; see Medicaid changes in 2027. The change can also surface mid-year: 42 CFR 435.916(d)(1) requires a review whenever the agency learns of a change that may affect eligibility.

Either way, Centers for Medicare & Medicaid Services (CMS) guidance says your state must keep your Medicaid going until it finds you ineligible under every Medicaid group you may qualify for (or you miss a deadline for requested information) and gives you advance notice and fair hearing rights. See Medicaid renewal.

If Your Medicaid Ends Anyway

A termination notice is frightening, but it isn't final. Federal rules cap the window to request a Medicaid fair hearing at 90 days from the date the notice is mailed; your state may set a shorter one, so go by your notice. See Medicaid appeals and fair hearings.

The 90-day reconsideration is narrower: if your Medicaid ended because you didn't submit the renewal form or necessary information, it lets you send the renewal form within 90 days of termination (or longer, if your state allows) and be reconsidered without a new application. States must offer the 90-day reconsideration for MAGI enrollees and may offer it for ABD enrollees. If you were found over an income or asset limit, the fair hearing is your route.,

The Medicare Side

Your Medicare initial enrollment period runs from three months before the month you turn 65 to three months after it.

Medicare Savings Programs are evaluated separately, under non-MAGI rules used only to decide that help. All four Medicare Savings Program groups are mandatory in every state and DC. Compare them by state.

What to Do First

  1. Find your renewal date and open every agency letter.
  2. On expansion Medicaid? Compare your countable savings with your state's ABD limit.
  3. Answer every request for information by its deadline.
  4. Ask about Medicare Savings Programs.
  5. If a notice says coverage ends, note its hearing deadline.

Protections to Ask About

Frequently Asked Questions

Will I lose Medicaid when I get Medicare?

Not automatically. Getting Medicare ends your place in the Medicaid expansion adult group, which excludes anyone entitled to or enrolled in Medicare, but your state must check every other basis of eligibility before ending your Medicaid., If another Medicaid group covers you, keeping full Medicaid with Medicare makes you a full-benefit dual eligible.

Can I stay on expansion Medicaid after 65 if I skip Medicare?

No. The Medicaid expansion adult group covers adults 19 to 64, so delaying Medicare past 65 doesn't keep you in it.

Does Medicaid check your savings after 65?

Medicaid doesn't check savings in MAGI groups, which have no asset test. In aged, blind and disabled (ABD) Medicaid groups, section 1940 of the Social Security Act has states verify assets electronically at renewal, not just at application.

Learn More

MedicaidWhat Is Medicaid? A Guide for Seniors and FamiliesWhat is Medicaid? A federal-state program each state runs, so whether Mom qualifies is a state answer. Who it's for, what it pays for, and how to apply. MedicaidMedicaid by StateMedicaid works differently in every state, from who qualifies to what's covered and how to apply. See what varies and jump to your state's full guide. MedicaidMedicaid Eligibility and Income Limits by StateMedicaid income limits for 2026 depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the figures and your state's limits. MedicareMedicare and Medicaid Dual EligibilityWhat dual eligible means: how Medicare and Medicaid coordinate, full vs. partial duals, QMB cost protection, automatic Extra Help, and integrated D-SNP plans. MedicareMedicare vs. MedicaidMedicare vs. Medicaid: Medicare is federal insurance for people 65+; Medicaid is state-run help for limited incomes. See costs, nursing homes and having both.

Not sure which situation you're in? Get personalized help sorting out your Medicaid before your next renewal at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.