Dual Eligibility
September 16, 2009 in Medicaid
People who are eligible for both Medicare and Medicaid coverage are “dually eligible”. Dual eligibility is available to people who have Medicare but need extra help paying some out-of-pocket Medicare expenses. These people may qualify to receive financial assistance from their state’s Medicaid program. If you have both Medicare and Medicaid, services will first be paid for by Medicare and then Medicaid will pay the difference. If you are eligible for full Medicaid coverage, Medicaid will supplement all services offered by Medicare and become your primary Medicare provider. Some people qualify for both Medicare and Medicaid (these people are also called “dual-eligibles”).
- If you have Medicare and full Medicaid coverage, most of your health care costs are covered whether you have Original Medicare or are in a Medicare Advantage Plan (like an HMO or PPO).
- Medicaid programs vary from state to state. They may also be called by different names, such as “Medical Assistance” or “Medi-Cal.”
- People with Medicaid may get coverage for services that aren’t fully covered by Medicare, such as nursing home and home health care.
- Each state may have different Medicaid eligibility income and resource limits.
- In some states, you may need Medicare to be eligible for Medicaid
