Both Medicare and Medicaid are government programs designed to provide healthcare coverage for certain Americans. There are different factors to determine eligibility for each one. Medicare provides coverage for seniors, or those 65 and older, while Medicaid provides coverage for low-income families. You may also be eligible for Medicare or Medicaid if you have a qualifying disability. Each program has a different set of qualifications and requirements. It is important to understand the two different programs in order to understand how you can save money on health insurance.
Generally, Medicaid eligibility is determined by an individual’s Modified Adjusted Gross Income (MAGI). Some people are exempt from this MAGI-based eligibility. For seniors 65 and older, or those who have blindness or a disability, Medicaid eligibility is determined by an individual’s Supplemental Security Income (SSI). Further, you must be a resident of the state in which you are applying, and you must be a citizen or a lawful permanent resident of the United States. Be sure to do some research to determine if you are eligible for Medicaid coverage. Learn more about Medicaid and find out if you qualify here.
Medicare Advantage and Medicaid
Many Medicare beneficiaries have found Medicare Advantage plans to be favorable. Medicare Advantage plans combine your Medicare Part A and Part B coverage into one plan while adding some extra benefits for things like vision, dental or hearing coverage. They may also provide Part D prescription drug coverage or a SilverSneakers fitness membership. Because Medicare Advantage plans are offered by private, Medicare-approved insurance companies, they provide their beneficiaries with a network of doctors and service providers that they must use in order to receive coverage.
In order to be eligible for Medicare Advantage, you must qualify for Original Medicare. You must also be enrolled in Medicare Part A and Part B and live in the area of the plan’s coverage. Learn more about the qualifications for Medicare Advantage here.
Overall, a Medicare Advantage plan provides more extensive coverage than an Original Medicare plan. If having coverage for vision, dental, hearing or prescription drugs is important to you, a Medicare Advantage plan may be able to provide the coverage you need.
Some individuals are eligible for both Medicare Advantage and Medicaid. Low-income seniors may find the benefits of both Medicare Advantage and Medicaid to be attractive and crucial for their needs. If you are dual-eligible, then Medicaid may be able to fill in some of the gaps of your Medicare coverage. Medicaid will cover some out-of-pocket expenses like Medicare Part B premiums, copayments, coinsurance and deductibles. Depending on your Medicare Advantage plan, certain things may be covered by Medicare Advantage while others may be covered by Medicaid. If your Medicare Advantage plan includes Part D prescription drug coverage, then it will be paid for by the plan rather than by Medicaid. Being enrolled in both Medicare Advantage and Medicaid can help you save lots of money on your healthcare. Do some research to find out if you can save money by qualifying for both Medicare and Medicaid. It is important to note that Medicare and Medicaid benefits vary between states, so be sure to look into coverage plans in your state.
Medicare Advantage Enrollment
If any of the benefits of Medicare Advantage sound attractive to you, consider enrolling in a plan. If you are interested in enrolling in a Medicare Advantage plan while on Medicaid, you can sign up for a Special Needs Plan (SNP). There are many different types of Special Needs Plans, but there is a certain type that is accommodating for those who are dual enrolled in Medicare and Medicaid. This type of plan is called a D-SNP. Not all areas have D-SNPs available. Medicare Advantage plans and Medicaid coverage vary from state to state, so be sure to look into the plans in your area to find out exact coverage and costs. If you want to sign up for Medicare Advantage, be sure to speak to an insurance professional to learn if you qualify and how to enroll. Do some research to find a D-SNP that fits your needs in your area.
Having both Medicare Advantage and Medicaid coverage is possible and can save you lots on health insurance. Because Medicaid coverage varies across states and Medicare Advantage plans vary from area to area, it is important to look into the exact plans in your area to determine coverage and costs. Contact a healthcare professional to see how a Medicare Advantage plan would work with Medicaid.