You may have Medicare, Medicaid or maybe both! Other than sounding similar, the words Medicare and Medicaid are very different government-sponsored health insurance programs, but they can work together. If you have both, you may qualify for a special type of Medicare Advantage plan.
Medicare and Medicaid are two government programs that help people pay for their health care. By now, you already know Medicare is generally for people who are older or disabled. If you need a refresher, head on over to the Medicare 101 page by clicking here. Medicaid is for people with low incomes. Essentially, these are the poor. These folks don’t have the money to pay for their own health health insurance.
Medicaid is an assistance program. It serves low-income people of every age and benefits vary from state to state. People on Medicaid usually pay no costs for medical expenses, however in some states small co-pays are required and they vary from state to state. It is run by state and local governments within federal guidelines. Qualifying income and resource levels are set by the feds. Every state decides what they’ll use to qualify applicants when calculating whether or not they’ll qualify.
If you are eligible for both Medicare and Medicaid, Medicare and Medicaid will work together to provide you with very complete health coverage. This means both working together should cover most, if not all out of pocket costs and you won’t get a bill.
People who qualify for both Medicare and Medicaid are said to be “dual eligible.” If you have Medicare and Medicaid, you may be eligible to enroll in a special Medicare Advantage plan that can provide additional benefits above and beyond what you get with either. This is accomplished by enrolling in a “Dual Special Needs Plan” also known as a “Dual-SNP” (pronounced “dual- snip”) plan. These plans are exploding in popularity, mainly because the insurance companies are paid handsomely by the federal government to manage the dual-eligible (Medicare and Medicaid) population due to their health status. The only problem is they’re hard to find and largely only available in metropolitan areas. I’ve got an article I’ve got queued up all about D-SNP plans which I’ll publish in a week or so. When I do, I’ll link back here.
In the meantime, if you think you qualify for Medicaid, click here to check out more information and apply. If you’re brave enough to research D-SNP plans in your area before I post, click here or call 1-800-MEDICARE (1-800-633-4227).
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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.