What are the benefits of having both Medicaid and Medicare?
Asked by: Tate Wolf | Last update: July 7, 2025Score: 4.1/5 (6 votes)
Why would a person have both Medicare and Medicaid?
A person may qualify for both Medicare and Medicaid based on their health and income level. If a person is dual-eligible, Medicare will usually pay for health expenses first, and Medicaid may help pay for out-of-pocket and noncovered expenses.
Why would you be on Medicare and Medicaid?
Yes – if you're 65 or older and meet your state's income requirements for Medicaid, you can sign up for both Medicare and Medicaid. Together, they offer more comprehensive health coverage at a lower cost.
How many people qualify for both Medicare and Medicaid?
12 million Americans have both Medicare and Medicaid coverage. This is known as being “dual eligible,” meaning they get benefits from both programs to help pay healthcare costs. Let's take a look at Medicare and Medicaid, how to qualify for dual eligibility and more.
What is a dual benefit?
If you qualify as a full-benefit dual-eligible beneficiary, you are enrolled in. Medicare and receive full Medicaid benefits. This means that Medicaid may cover. services that Medicare does not cover, such as4,14: If you are someone who qualifies as a dual-eligible beneficiary, Medicare will be the first program.
How Medicaid Works with Medicare | Are you Dual Eligible?
What are the disadvantages of dual insurance?
- Complex Management: Involves more paperwork, potential claim delays, and higher premiums.
- Coordination of Benefits: Primary insurance pays first, and secondary covers remaining eligible costs, requiring thorough understanding and communication.
How do I know if I am dual eligible?
According to the Centers for Medicare & Medicaid Services, you may qualify for dual eligible benefits if5: You are enrolled in Original Medicare (Part A, Part B, or both); and. Receive full Medicaid benefits; or. Get help with your Medicare out-of-pocket costs through a Medicare Savings Program (MSP)
Will I lose my Medicaid if I get Medicare?
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.
What is the best health insurance plan for seniors?
Medicare is the best health insurance option for seniors and retirees. Medicare is the cheapest health insurance with the best benefits for people age 65 and older or who have a qualifying disability. You can choose between two different options: Original Medicare and Medicare Advantage.
What does Medicaid not cover?
Though Medicaid covers a wide range of services, there are limitations on certain types of care, such as infertility treatments, elective abortions, and some types of alternative medicine. For example, the federal government lists family planning as a mandatory service benefit, but states interpret this differently.
Does Medicare cover 100% of hospital bills?
Whether you're new to Original Medicare or have been enrolled for some time, understanding the limitations of your coverage is important as you navigate decisions about your healthcare. One of the main reasons why Original Medicare doesn't cover 100% of your medical bills is because it operates on a cost-sharing model.
How much does Medicaid cost per month?
Amounts. Most states adjust premium amounts by beneficiary income, with approved possible charges ranging from approximately $5 to $74 per month. Four states (AR, AZ, MI, and MT) have approved waivers to require monthly premium payments as a percentage of income.
What happens if you make too much money while on Medicaid?
If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.
Does Medicare cover dental?
In most cases, Medicare doesn't cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures.
What are the four types of Medicaid?
- State-operated fee-for-service (FFS)
- Primary care case management (PCCM)
- Comprehensive risk-based managed care (MCO model)
- Limited-benefit plans.
What disabilities are eligible for Medicare?
Qualifications for Those with Disabilities to Get Medicare
Medicare eligibility for those under 65 includes people who already receive Social Security Disability Insurance benefits, those diagnosed with ALS (Lou Gehrig's disease) and individuals living with End-Stage Renal Disease.
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Who has the cheapest insurance for seniors?
Our research found that Auto-Owners, Travelers, Geico, USAA and Nationwide may be the cheapest car insurance companies for seniors based on average rates from Quadrant Information Services. Rates provided are for a 70-year-old driver with a clean driving record.
What type of medical insurance do most retirees have?
Since Medicare pays first after you retire, your retiree coverage is probably similar to coverage from a Medicare Supplement Insurance (Medigap) policy. Both are likely to offer benefits that fill in some of the gaps in Medicare coverage—like coinsurance and deductibles.
Is it better to be on Medicare or Medicaid?
While Medicare is the primary payer for medical needs, Medicaid can cover costs that Medicare coverage does not. When you visit a provider that takes both Medicare and Medicaid, Medicare pays first for the cost of your care. Medicaid pays second, covering copays and other costs not covered.
What does Medicaid cover for seniors?
Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services including prescription drugs, case management, physical therapy, and occupational therapy.
Why do some people have dual Medicare and Medicaid?
Medicare-Medicaid enrollees include people ages 65 and over who are in relatively good health but have limited financial resources and people who at one time, may have had more financial resources, but spent their income and wealth on health or long-term care costs.
Do dual citizens get Social Security?
A reader from Michigan asks if dual citizenship will affect Social Security benefits. "Can I continue to receive my Social Security retirement benefit if I have dual citizenship with Mexico?" Yes, absolutely. You don't have to be a U.S. citizen to collect your retirement benefit as long as you meet specific criteria.
What is the difference between QMB and Medicaid?
How is the QMB program different from Medicaid? Medicaid, also known as Medical Assistance or QMB Plus, provides benefits for services not normally covered by Medicare. QMB, which is partial Medicaid, helps pay for services only if they are covered by Medicare.