G-F6HB1LKQWZ Medicaid | How Medicaid and Medicare Work Together

Medicaid

“Medicaid is a joint federal and state program that helps pay health care costs if you have limited income and resources and meet other requirements. Some people qualify for both Medicare and Medicaid.” 

Medicaid is either for people with certain health conditions or for people below a certain income and asset level. 

Did you know that about 20% of Medicare beneficiaries also receive some level of Medicaid? 

If you think you may qualify for Medicaid, you should either contact your local Social Services department or your state Medicaid office. For Virginia Medicaid, go here.

Levels of Medicaid | How Medicaid and Medicare Work Together

Medicaid comes in several different levels. What level you qualify for determines how much Medicaid works with and/or covers your Medicare and healthcare costs.

I summarize Medicaid coverage in this order:

  • Low level Medicaid covers your Medicare Part B premium.
  • Mid level Medicaid covers your Medicare Part B premium plus your Medicare deductibles and copays.
  • High level Medicaid in Virginia qualifies you for what is called CCC Plus (Commonwealth Coordinate Care). This level of Medicaid offers additional benefits and support and instead of being administered by the State, the State turns over the Medicaid administration to one of six private insurance companies. Go here for the CCC Plus website.

See the image below for specific info about the different levels of Medicaid and check out this link for more info.

 

Dual Eligibles

If you are on both Medicare and Medicaid, then you are considered a Dual Eligible beneficiary. Dual Eligibile recipients may have more Medicare Advantage plans available to them as compared to just a Medicare beneficiary. And as noted above, certain Dual Eligibles will have the option for what are called DSNP’s (Dual Special Needs Plan). These are Medicare Advantage Part C plans that are specifically designed for Dual Eligibles. They offer enhanced benefits above and beyond traditional Medicare and Medicaid coverage.