You must fulfill the standards of each program in order to be eligible for both Medicare and Medicaid. Age (65 or older) or certain medical conditions, including a handicap or end-stage renal disease, are usually the determining factors for Medicare eligibility.
Medicaid is need-based, on the other hand, which means that your eligibility is determined by your financial resources and income, which differs by state.
What is meant by dual eligibility?
You can find out if you qualify for dual eligibility by applying for Medicaid through your state’s Medicaid office if you currently have Medicare.
In the same way, you should apply for Medicare as soon as possible if you are on Medicaid and turning 65 or if you satisfy other requirements for Medicare.
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You can get information on the precise income and asset restrictions from the Medicaid office in your state to see if you qualify.
Medicaid is the secondary payer, paying expenditures that Medicare may not cover entirely, such as some deductibles and co-payments, and services like long-term care that Medicare does not normally cover. Medicare, if eligible, is often the primary payer for covered services.
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Medicare Savings Programs can also help with Medicare premiums and other costs for dual-eligible persons.
“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,” as per the official Medicare website.
“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.”
