Medicare with Medicaid

Dual Eligibility: Medicare with Medicaid

Maximizing Benefits with Medicare and Medicaid

If you qualify for both Medicare and Medicaid, you are considered “dual-eligible.” This means you can take advantage of both programs to cover your healthcare needs comprehensively. At ACBS Insurance Services, we specialize in helping dual-eligible individuals get the most out of their benefits. We’ll guide you through your options, ensuring you receive the medical services you need without the financial burden.

A doctor consulting with a senior couple

How Medicare and Medicaid Work Together

Medicare and Medicaid each offer different types of coverage, but when combined, they provide a robust safety net for healthcare costs.

Medicare

Covers hospital (Part A), medical services (Part B), and often prescription drugs (Part D).

Medicaid

Assists with healthcare costs such as premiums, copayments, and out-of-pocket expenses that Medicare does not cover.

Being eligible for both programs means you’ll pay little to no out-of-pocket costs for healthcare services, including doctor visits, hospital stays, and prescription drugs. Our team at ACBS will work with you to identify the best plans that optimize your dual coverage, ensuring you have seamless access to the care you deserve.

Key Benefits of Dual Eligibility

Low or No Out-of-Pocket Costs:

Medicaid helps cover expenses such as Medicare premiums, deductibles, and copayments.

Prescription Drug Savings:

Dual-eligible individuals automatically qualify for Extra Help, reducing prescription drug costs significantly.

Comprehensive Care:

Access to Medicare and Medicaid Advantage Plans (D-SNPs) that provide additional benefits like dental, vision, hearing, and transportation services.

Coordination of Care:

We help coordinate your care so that both Medicare and Medicaid benefits are maximized for the best coverage at the lowest cost.

Types of Dual Eligibility

ACBS can help determine your level of eligibility and match you with the right plan that suits your financial and healthcare needs.

Full Dual Eligibility:

Medicaid pays for most out-of-pocket expenses, including Part A and B premiums, deductibles, and copayments.

Partial Dual Eligibility:

Medicaid may cover part of your Medicare premiums or some other costs, depending on your income and state-specific rules.



How ACBS Can Help You

Navigating dual eligibility can be complicated, but ACBS is here to make it easy. Our experienced agents provide:

 

  • Personalized Guidance: We’ll assess your healthcare needs and find the best Medicare and Medicaid plans for you.
  • Support with Enrollment: From completing applications to explaining benefits, we assist with the entire process.
  • Ongoing Support: After enrollment, we continue to review your coverage, making adjustments to ensure you’re always receiving the best care at the lowest cost.
A doctor consulting with a senior woman

Frequently Asked Questions

Yes. Medicare is your primary insurance, but Medicaid helps cover costs that Medicare doesn’t, such as out-of-pocket expenses and additional services like dental or vision care.

D-SNPs are special Medicare Advantage Plans designed specifically for people eligible for both Medicare and Medicaid. These plans often include extra benefits, like transportation and meal services, tailored to dual-eligible individuals.

No, if you are dual-eligible, you can still keep Medicaid coverage even if you enroll in a Medicare Advantage Plan. We can help you find a D-SNP that fits your needs.

Get the Most from Your Medicare and Medicaid Benefits

At ACBS Insurance Services, we specialize in making sure you get the full value of your Medicare and Medicaid benefits. Contact us today to explore your options and secure comprehensive coverage that works for you.

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