Medicare & Medicaid

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HOW DOES MEDICARE WORK

WITH MEDICAID?

Medicaid is state assistance for individuals with low income and assets.  Having A & B of Medicare as well as Medicaid, is called being Dual Eligible.  

 

There are varying levels of Medicaid such as QI, QWDI, SLMB, SLMB+, QMB, and FBDE.  Most people with Medicaid also qualify for Low Income Subsidy or Extra Help which is a federal program that helps lower prescription drug copays and plan premiums.

 

At the higher Dual Eligible levels, Medicare pays primary and Medicaid pays secondary for doctors and hospitals.  If you don't choose a plan for yourself, the state will automatically select a Part D plan for you.  Alternatively, you would also be eligible for a Special Needs Plan.

Special Needs Plans (SNPs) are Medicare Advantage plans that offer extra benefits on top of Medicare and Medicaid without sacrificing  the medical and prescription benefits you're already receiving.

Some of the benefits that SNPs offer include a reduction of Part D copays, Dental, Hearing Aids, Eyeglasses, Transportation, Grocery Cards, Over-the-Counter credits, Medical Alert Systems, and more!

Our team is knowledgeable in working with veterans and Tricare recipients.  

THINGS TO CONSIDER

  • What level of Medicaid do I have?

  • Does Medicaid cover out-of-state?

  • Can I still get my medications at my local pharmacy?

  • Will this reduce the amount I pay for Part B of Medicare?

  • I'm under 65 and just over the income limits.  Can I buy-in to Medicaid?

  • Do I have a  spend down?

  • I have dependents. How does that affect my eligibility?

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