Medicaid and Medicare

People who are eligible for both Medicaid and Medicare are often confused by the difference between Medicaid and Medicare. Let’s first address this difference.

What is “Medicaid”?

The last 3 letters in the word Medicaid will give you the easiest definition of the word. The last three letters are “AID”- Medicaid is “aid” for people who make under a certain level of income.

Medicaid is a health insurance program funded by Federal and State governments, that pays costs for certain individuals and families with low incomes and, in some cases, limited resources.

What is “Medicare”?


The last 4 letters in the word Medicare is “CARE”. Medicare is health “care”, or insurance for people 65 years of age and older, or people on disability. You may also qualify for Medicare with end-stage kidney failure.

Dually Eligible Beneficiaries


If you are turning 65 and you are currently receiving Medicaid benefits you may be considered “Dual Eligible”. “Dually Eligible beneficiaries” generally describes beneficiaries enrolled in both Medicare and Medicaid. When you are eligible for both Medicaid and Medicare, Medicaid may pay for your Medicare health insurance. That’s right, you may not have to pay for your Medicare health insurance! This is based on a person’s Medicaid eligibility.

Medicare Advantage Dual Eligible Plans


People with both Medicare and Medicaid may benefit greatly from enrolling in a Medicare Advantage Plan for the Dually Eligible. These plans are often referred to as Dual Eligible Special Needs Plans (D-SNP). A Dual Eligible Plan often has no premium and no copays for services. Some additional benefits include but are not limited to the following.

  • Dental

  • Fitness memberships

  • Hearing

  • Nutrition programs

  • Access to more Doctors and hospitals

  • Over-the-counter drugs

  • Transportation to Doctor visits

  • Vision

  • Wellness programs

If you are dual eligible you may also be eligible for the “Extra Help Program”. The Extra Help Program helps pay Medicare’s monthly premiums, annual deductibles, and co-payments for beneficiaries who have or want Part D Prescription Drug coverage, and meet certain income and resource limits.

As you can see, Medicare has many programs available for Dual Eligible individuals. If you are currently on Medicaid and eligible for Medicare, give us a call to make sure you are making the most of your benefits!

Need more help from the Medicare Experts?

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