Medicare and Medicaid: two very similar-sounding programs that are not the same! Just take a look at their differences below:
Medicare
- Federal health insurance program
- Provides health coverage for seniors 65 and older
- Can provide health coverage for individuals under 65 who have a disability
- Does not base eligibility on your income
VS.
Medicaid
- State and federal health insurance program
- Provides health coverage for individuals at any age with low income
- Individuals, families, and children, pregnant women, the elderly, and those with disabilities may qualify
- Eligibility is based on income and your state’s requirements
If your qualify for both, you can both at the same time—known as dual eligibility. You would then be eligible for a Dual Eligible Special Needs Plan (D-SNP)
Whether you qualify for one or the other will depend on your situation, but many actually qualify for both, which can lead to the misconception that qualifying for one means automatic eligibility for the other. They’re distinctly different programs with strong similarities, but can work in your favor if you qualify for both.
So, do you qualify for both? Zero Bullshit Insurance can help you figure that out and cut through all the unnecessary information to get you those answers.
What Are The Eligibility Requirements?
Medicare is available to those who are 65 or older. If you are not yet 65, you can still get Medicare if you have been receiving disability benefits from Social Security for 24 months or more.
Medicaid eligibility is income-focused. You must earn at or below a certain amount based on your state’s requirements for Modified Adjusted Gross Income (MAGI). Some states allow you to navigate this if your earnings are too high, yet you are considered medically needy. If you’re medically needy, you can deduct your medical costs from your income in order to meet your state’s MAGI requirement.
What Are The Benefits Of Having Both?
When you have both, the two plans coordinate the coverage. When you get a treatment or service, Medicare will pay first, and then Medicaid will cover what it can of the rest. You will only have to pay for what is left over after that.
By being enrolled or qualifying for both, you have the option of enrolling in a Dual Eligible Special Needs Plan (D-SNP). This is a type of Medicare Advantage plan exclusive to those who qualify for both Medicare and Medicaid. It’s a comprehensive plan because it bundles the benefits of Medicaid and Medicare into one policy. There’s also guaranteed prescription drug coverage, which is another reason why this is an appealing option.
Is A D-SNP Right For You? Let’s Find Out.
At Zero Bullshit Insurance, we cut through all the bullshit to ensure you get the answers to your Medicare questions.
Want to learn more about D-SNPs? We have you covered and can find which plans are available to you specifically.
Need to know what makes you eligible for Medicare and Medicaid? We’ll help you through that process.
No more wondering how you can get the coverage you need when you work with us. Do yourself a favor and reach out to us today for a free consultation.
