What is Medicaid?

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is administered by states, according to federal requirements.

What is Medicare?

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and individuals with End-Stage Renal Disease (ESRD).

Can you have both Medicare and Medicaid?

Some individuals have both Medicare and Medicaid generally making them dual eligible.  These Dual Eligible clients are low-income individuals who are receiving full Medicaid benefits and/or receiving help with Medicare premiums and co-payments through the Medicare Savings Program (MSP). The Medicare Savings Program has four different levels:

  • Qualified Medicare Beneficiary (QMB): helps pay for Part A premiums, Part B premiums, deductibles, coinsurance, and copayments
  • Specified Low-Income Medicare Beneficiary (SMB): helps pay for Part B premiums
  • Qualifying Individual (QI): helps pay for Part B premiums on a first-come first-serve basis
  • Qualified Disabled Working Individual (QDWI): helps pay for Part A premiums

Dual plans are offered by private insurance companies and work together with the individual’s Medicaid plan and cover eligible doctor visits, hospital stays and prescription drugs. Most dual plans are zero premium and provide extra benefits, that can include dental, vision, hearing, and transportation. Individuals who qualify for a dual plan can join or switch their plan one time in each quarter the first nine months of the year and any Medicare beneficiary can make a change during the Annual Enrollment Period (AEP) which is October 15th – December 7th.

Are you enrolled in both Medicare and Medicaid and want to know more about your options? Call Hovis & Associates at (636) 937-4343, We make Medicare & Medicaid SIMPLE!

Are you an agent looking to learn more about Medicare & Medicaid? Join us for our webinar, “Coffee Talk,” on Wednesday, March 24, 2021 at 9:00 A.M. Contact Lacey Robertson at (888) 613-6196 or laceyrobertson@hovisandassociates.com to register.

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