Can You Have Medicare and Medicaid? – Overview
A person can have both Medicaid and Medicare, provided they fulfill certain eligibility requirements. For instance, some people qualify for Medicare based on their age (over 65 years) or if they have a disability. The same person may also qualify for Medicaid if they meet the state-specific eligibility requirements of their state.
A person who has Medicaid and Medicare is usually referred to as “dual eligible” and has access to benefits from Medicare and Medicaid too.
Dual Health Insurance Plans
Dual health plans are made for people who have access to Medicaid and Medicare. They are a special type of Medicare Part C (Medicare Advantage Plan).
Dual health plans combine hospital, medical and prescription medicine coverage. As a result, dual-eligible persons can keep all their Medicaid benefits and enjoy additional benefits than the Original Medicare coverage. The best part is that such persons can get the combined benefits of Medicare and Medicaid with US$ 0 premium plans.
Can You Have Medicare and Medicaid – Dual Health Insurance Plans
Dual health insurance plans are often called “dual special needs” plans. Private health insurance companies usually offer them. So, you can find a dual health plan that suits your health and medical insurance needs. Lastly, it is important to remember that being on a dual health plan does not affect your Medicaid benefits or eligibility.
Now that you know about dual health plans and that many people are eligible for the combined benefits of Medicare and Medicaid, let’s take a closer look at the specific benefits such individuals enjoy.
What Is Medicare and Its Benefits?
Medicare is an insurance policy developed and operated by the US federal government for citizens who are 65 years or older and have difficulty paying the expenses of medical and health care needs. This insurance program supports seniors and their families who need financial assistance to fulfill their medical and health needs.
Apart from seniors, people who are under 65 years but with a significant disability are also eligible for Medicare benefits. Such cases are usually evaluated on the eligibility requirements and the details of individual insurance programs. In addition, people suffering from end-stage renal (kidney) disease are also eligible to receive Medicare benefits.
Medicare benefits are usually provided through two plans – Original Medicare and Medicare Advantage.
Original Medicare is a government-sponsored medical insurance program that many senior Americans use as their primary health insurance. Under this, Medicare Part A covers inpatient hospital services, such as coverage for hospital visits, hospice care, (limited) nursing facility care and at-home health care. Medicare Part B covers outpatient medical services, such as coverage for preventive, diagnostic and treatment services for numerous health conditions.
Medicare Advantage, or Medicare Part C, is an insurance program for people who want coverage of original Medicare but with wider choices of coverage options. Medicare Advantage plans can be bought from private insurance companies.
Most Medicare Advantage plans cover the cost of prescription drugs, dental care, vision care and hearing care, which are not included in the Original Medicare benefits.
In short, Medicare health insurance is divided into the following types of plans:
Medicare Part A – This provides coverage for most inpatient medical care, including hospital stays, hospice services, and some healthcare, along with limited skilled nursing services.
Medicare Part B – This provides coverage for outpatient medical services, such as outpatient hospital care, preventive care, physician appointments, and certain medical equipment.
Medicare Part C – This is also called Medicare Advantage and covers and combines the benefits of Medicare Part A and B, including additional services, such as dental, vision, and hearing care costs, as well as prescription drug coverage.
Medicare Part D – This is an approved plan and runs according to federal rules, which is solely meant to cover the cost of prescription drugs.
What is Medicaid and Its Benefits?
Medicaid is a nationwide health and medical insurance program combined by the US state and federal governments. This public health insurance program aims to assist low-income families in accessing affordable healthcare services.
Medicaid coverage may include the cost of major hospitalizations, treatments, and routine medical care. Medicaid currently serves millions of adults, children, and people with disabilities every year.
In short, Medicaid benefits include coverage for the cost of the following:
- Lab and x-ray services
- Family planning services (birth control, midwives services, etc.)
- Inpatient and outpatient hospital services
- Nursing facility services (adults)
- Health screenings and applicable medical treatments for children
- Surgical and dental services (adults)
As Medicaid is different in each state, we recommend you contact a caseworker to evaluate your situation and help you apply for Medicaid health insurance cover.
Conclusion
Dual health plans are incredibly helpful to seniors and those suffering from disabilities. The combination of Medicare and Medicaid benefits helps to cover almost all aspects of healthcare that seniors and the disabled may need.
If you want additional information on this, you can simply check the official website.
See Also
Does Medicare Cover Dental Implants?
Centers for Medicare and Medicaid Services
Does Medicaid Cover Chiropractic?
I am a dedicated healthcare researcher and an enthusiast specializing in medical grants, medical education and research. Through my articles, I aim to empower healthcare professionals and researchers with valuable insights and resources to navigate these critical aspects effectively.
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