Medicaid Medicare Your Coverage Options

Four things to know if your income is low and you have Medicare

Written by Diane Archer

More than 9.6 million older adults and people with disabilities are eligible for both Medicare and Medicaid. They are different programs that work together to provide a more comprehensive set of benefits for people with low incomes.

  1. Medicaid picks up many health care costs that Medicare does not cover: Depending upon your income and assets, along with which state you live in, you might qualify for Medicaid in addition to Medicare. Medicaid would be your secondary insurance, paying after Medicare.  It generally covers the gaps in Medicare, including the Part B premium, the Part D drug premium, deductibles and coinsurance. It sometimes covers routine dental care and travel to and from the doctor’s office and some long-term care. No matter where you live, if you meet state-specific criteria, you will have coverage for nursing home care.  Depending which state you live in, which matters a lot, and your care needs, you might also be eligible for home or community-based care.  There are also several demonstration projects underway testing new ways to deliver home care for people with Medicare, in one project with the help of therapists, nurses and handymen. Click here to learn more.
  2. Your state Medicaid office or SHIP program can help you know whether you qualify for Medicaid or other low-income assistance.  Even if your income or assets are over the 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. To contact your state Medicaid office, click here and to learn about free and low-cost resources, including the State Health Insurance Programs (SHIP), click here.
  3. Medicaid might require you to switch out of traditional Medicare: Some states may require you to enroll in a private Medicaid plan if you sign up for Medicaid. You would need to give up traditional Medicare coverage, which would limit your choice of doctors and hospitals to that plan’s network of doctors and hospitals.
  4. Medicare Savings Programs will cover some of the gaps in Medicare if your income is low, even if you are not enrolled in Medicaid.  To learn more about programs, other than Medicaid, that will pick up some of your health care costs, click here.

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