Medicaid and Medicare are almost identical. These federal health insurance program are both designed for specific groups of individual. If you are already enrolled in Medicare, which is less superior then Medicaid, and wish to apply for the latter, you may have certain concerns regarding the possibility of being under both insurance programs.
Will you lose your Medicare of you apply for Medicaid? Will my Medicare affect my Medicaid? These, I believe, are the few questions that may pass through your mind.
In this article, you’ll understand if indeed getting Medicaid affect Medicare.
What is Medicare?
Medicare is a United States Federal government health insurance program that makes health care services more affordable. The plan usually cover individuals age 65 or older, younger people who meet the eligibility requirements, including individuals with certain illnesses.
Medicare is divided into diverse plans that cover a panoply of healthcare situations, some of which come at a cost to the insured individual. While this allows the program to provide customers with extra choice in terms of costs and coverage, it also introduces complications for individuals who wish to sign up.
Who is Eligible for Medicare?
Medicare eligibility depends on some criteria. Anyone who has lived in the U.S legally for a minimum of five years and is 65 or older qualifies for Medicare coverage. Enrollment in both parts A and B is automatic for any individual who receives Social Security Benefits. On the other hand, part D coverage is optional and enrollment must be done by the person.
What is Medicaid?
Medicaid is a public health insurance program that provides health care coverage to specific groups of people, including low-income families, pregnant women, some category of children, disabled adults, etc.
Medicaid is funded by the federal government and the state. It is run at the state level, denoting that coverage, administration, and eligibility vary greatly from state to state. In addition, it available only to individuals and families who meet certain income-based criteria. Recipients of this government-funded program are U.S. citizens, permanent citizens, or illegal immigrants.
Who is Eligible for Medicaid?
People eligible for Medicaid are as follows
- Individuals with low-income
- Pregnant women
- Seniors
- Specific groups of Children
- Disabled individuals
Will you lose your Medicaid when you become eligible for Medicare?
You won’t lose your Medicaid eligibility simply because you enrolled or became entitled for Medicare. Provided your income is below the limits for Medicaid eligibility in your state, you will enjoy benefits from both coverage. Over 8 million individuals have both Medicare and Medicaid.
When enrolled in Medicaid and Medicare, Medicare becomes your main insurance and pays for your medical bills first, and Medicaid becomes secondary, paying for services that Medicaid can’t cater to and also settling most of your out-of-pocket expenses in Medicare (copays, deductibles, premiums).
When you qualify for Medicare, you must start receiving your prescription drug coverage from Medicare’s Part D drug program, not from Medicaid. You will automatically qualify for the federal extra help program, which enables you to obtain Part D drug coverage without praying premiums or deductibles and paying only low copays for your drugs.
However, to obtain this coverage, you still have to select a Part D drug plan and register for it. To make sure that you select a plan that gives you max coverage at the lowest cost, you may want to reach out to your health insurance assistance program (SHIP).
Do you need an Elder law attorney?
If you need an elder law attorney for matters regarding your elderly loved one, don’t hesitate to call our office. Or if you are a senior and you need help with applying for Medicaid, you can also contact us for assistance.
In addition, in the event that your assets and income are above the threshold, signaling your ineligibility for Medicaid, you can contact us if you wish to set up a Medicaid Asset protection Trust. However, you must have the Medicaid look back period in mind. This means that, after placing your assets in this trust, you are to wait for the next 5 years before applying for Medicaid to avoid any form of sanction.
