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What is Dual Eligibility? The Benefits of Accessing Both Medicare and Medicaid

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When an individual is considered “dual eligible,” they are eligible for both Medicare and Medicaid. Contact us today if you or a loved one may be dually eligible for reduced health insurance premiums. By carefully analyzing each client’s circumstances, we can reliably ascertain whether or not they are entitled to a particular benefit.

Keep reading to find out more about Medicaid, Medicare, and dual eligibility.

What is Medicare?

Medicare, like Medicaid, is a federally administered health insurance program. The program covers the cost of medical care for those who are 65 or older or who have a disability that meets certain requirements. Parts A, B, C, and D comprise the Medicare coverage spectrum.

Original Medicare: Part A and Part B

Original Medicare refers to Medicare Parts A and B. Medical care and regular outpatient services are covered by Part B, while hospitalization and similar inpatient care are covered by Part A.

Medicare Part C and Part D

Medicare Advantage is another name for Medicare Part C Additional services, which may or may not be covered, are added to Original Medicare coverage. Prescription drugs are covered by Part D. Plans that combine Part A and Part B of Medicare may offer drug coverage if they are called Medicare Advantage Prescription Drug (MAPD) plans. Prescription drug coverage is also available as a stand-alone product.

What is Medicaid?

The government also operates the health insurance program known as Medicaid. Medicaid provides health insurance to over 80 million Americans, including those with low incomes and specific groups such as pregnant women, the elderly, and the disabled. Medicaid may be a state-run program, but it must adhere to standards established by the federal government’s Centers for Medicare & Medicaid Services (CMS).

What does “Dual Eligible” mean?

People who meet the requirements for both Medicare and Medicaid are called “dual-eligible.” Those who qualify for benefits in two categories include…

  • insured by Medicare Parts A and B,
  • being fully covered by Medicaid, and/or
  • having their Medicare premiums or out-of-pocket costs covered by the government.

When a person is eligible for both Medicare and Medicaid, Medicare will cover the costs first. What is covered varies from one state to the next. Talk to one of our dependable advisors in your area to get information about health insurance plans.

The knowledgeable advisors at Medicare Advisors can assist those with dual eligibility in finding affordable health coverage options. We will investigate all potential cost-cutting avenues, including Medicare and Medicaid, and manage the application and enrollment procedure.

Get local answers to health insurance questions.

Our neighborhood experts can lend a hand to you or a loved one in your community who is looking into dual-eligible health insurance options. If you have questions about health insurance plans, you can contact us at (877) 255-0284 at no cost. Plan a phone call or send this to a friend or family member.

 

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