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Leonard "Lenny" Rosen

MEDICARE INSURANCE AGENT

Dual Special Needs Plans

Medicaid and Medicare: You can have both.

The difference between Medicaid and Medicare.

The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.

What is Medicaid?

Medicaid is a way to get health care at a lower cost or sometimes at no cost to you. Medicaid is managed by each state, so the eligibility requirements can change from state to state. Your state may even have its own name for its Medicaid program. It’s important to remember that you have to recertify for Medicaid each year.

Medicaid typically covers:

  • Children
  • Pregnant women
  • Elderly adults and people with disabilities
  • Eligible low-income adults

What is Medicare?

Medicare is a national health insurance program run by the federal government. Medicare covers:

  • People age 65 and older.
  • Some people under age 65 who may qualify due to a disability or another special situation.

Medicare helps millions of American seniors and disabled individuals cover some of their health care costs. There are 4 different parts to Medicare. This helps give people more health care choices, so they can pick the health care plan that best meets their needs.

How can you get both Medicaid and Medicare?

Some people qualify for Medicare because of age (they’re age 65 or older) or due to having a disability. They’re also eligible for Medicaid because they meet the requirements to qualify for Medicaid in their state. These people are “dual eligible” because they’re eligible for both Medicaid and Medicare.

What are dual health plans?

Dual health plans are designed just for people who have both Medicaid and Medicare. They’re a special type of Medicare Part C (Medicare Advantage) plan. Dual health plans combine hospital, medical, and prescription drug coverage. You’ll keep all your Medicaid benefits. Plus, you could get more benefits than with Original Medicare. And you could get it all for a $0 plan premium.

Dual Special Needs Plan: For People with Medicare & Medicaid

Some people are eligible to have both Medicare and Medicaid. These people are considered “dual eligible,” and they also qualify to enroll in a special kind of Medicare Advantage plan known as a Dual Special Needs Plan (D-SNP).

 

What Is A Dual Special Needs Plan?

 

A Dual Special Needs Plan is a special kind of Medicare Advantage coordinated-care plan. It is an all-in-one plan that combines your Medicare Part A and Part B benefits, your Medicare Part D prescription drug coverage, your Medicaid benefits and additional health benefits such as vision, dental or fitness.

 

Who Can Get A Dual Special Needs Plan?

 

You can get a Dual Special Needs Plan if you meet the following qualifications:

 

1.    You are eligible Medicare and Medicaid and have both.

2.    You have Medicare Part A and Part B.

3.    You live in the plan’s area.

 

What Does A Dual Special Needs Plan Cover?

 

Just like any other Medicare Advantage plan, a Dual Special Needs Plan will include coverage for Medicare Part A and Part B. It will also include Part D prescription drug coverage and extra benefits not provided by either Medicare or Medicaid.

 

Examples of extra benefits a Dual Special Needs Plan may provide include:

 

  • Credits to buy health products
  • Transportation assistance
  • Care coordination via a personal care coordinator
  • Personal emergency response system (PERS)
  • Tele-health options such as virtual medical visits with your doctor
  • Worldwide emergency coverage

 

The extra benefits offered will vary by plan, provider and location.