Medicaid Medicare Your Coverage Options

8.3 million people benefit from both Medicare and Medicaid

Written by Diane Archer

Medicaid is a joint federal and state public health insurance program for 70 million vulnerable people in the United States, funded in large part by the federal government and in some part by each state. Today, 8.3 million people benefit from both Medicare and Medicaid, 4.6 million older adults and about 3.7 million people with disabilities. People with Medicare and Medicaid are sometimes called “dual-eligibles.”

Medicaid covers about 15 percent of people with Medicare. Medicaid is a cost-effective program delivering a broad benefit package to older adults at about 20 percent less cost than private insurance. That said, a June 2015 Kaiser Family Foundation survey shows that Medicaid offers similar access to care as private insurance.

People with both Medicare and Medicaid have lower incomes and fewer assets than people who do not qualify for Medicaid. More than 85 percent of them have annual incomes below about $16,500. Even if your income or assets put you above the Medicaid eligibility limit, many states have what are called “spend-down” programs that allow you to qualify for Medicaid after you have spent some of your own money for health care. You should know that if you own a home, Medicaid does not count it as an asset. 

States must provide a minimum set of Medicaid benefits and have flexibility in terms of offering additional benefits. People with Medicare and Medicaid generally have low out-of-pocket costs. Medicaid helps cover Medicare premiums and out-of-pocket costs. And, as or more importantly, Medicaid also pays for some key services that Medicare does not cover, including community-based long-term services and supports, and nursing home care. And, it covers a wide range of behavioral health services.

About one-third of Medicaid’s budget goes to paying for long-term services and supports. More than half of Medicaid spending on long-term services and supports is for care at home or in the community. The Program for All-inclusive Care for the Elderly or PACE is a  Medicare-Medicaid program. At the same time, Medicaid covers 64 percent of all nursing home residents.

Click here to find out if you qualify for Medicaid. Many states allow you to apply on online. Click here to apply. And, click here to contact your state for application and renewal information. And, for simple health and retirement advice you can trust, subscribe to our weekly Just Care feed.

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http://kff.org/health-reform/issue-brief/medicaid-moving-forward/

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