Medicare and Medicaid: To qualify for both Medicare and Medicaid, you have to meet the eligibility requirements for each.
Medicare eligibility is typically based on age (65 or older) or specific health conditions, like end-stage kidney disease or a disability. Medicaid, on the other hand, is need-based, meaning it’s primarily determined by your income and financial resources, which vary depending on the state you live in.
If you qualify for both programs, you’re known as “dual eligible,” which can help reduce medical costs since each program covers different aspects of healthcare.
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Dual eligibility: what is it?
To find out if you are eligible for dual eligibility, you can apply for Medicaid through the Medicaid office in your state if you currently have Medicare. In a similar vein, you should apply for Medicare as soon as possible to guarantee coordinated coverage if you are on Medicaid and approaching 65 or if you meet other requirements of Medicare.
You can get information from the Medicaid office in your state about the precise income and asset limits.
Medicaid acts as the secondary payer, paying for services like long-term care that Medicare doesn’t normally cover and costs like certain deductibles and co-payments that Medicare may not cover in full. Medicare, once qualified, is typically the primary payer for covered services.
Medicare Savings Programs, which help with Medicare premiums and other costs, may also be available to dual-eligible people.
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“People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you’re a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have,” the official Medicare website reads.
“If you’re dually eligible, Medicare covers your prescription drugs. You’ll automatically be enrolled in a Medicare drug plan that will cover your drug costs instead of Medicaid. Medicaid may still cover some drugs that Medicare doesn’t cover.”
