Can You Have Medicare Advantage and Medicaid?
Yes, you can have both Medicare and Medicaid, but only if you qualify for both programs.
People who qualify for both are called “dual eligibles,” where Medicare pays first and Medicaid covers what’s left.
Here’s what makes this so powerful
These two programs team up to eliminate most out-of-pocket costs while adding extra benefits.
This little-known dual coverage strategy could dramatically slash your healthcare expenses while expanding your benefits beyond what either program offers alone.
Let’s explore how you can benefit from this powerful combination.
Key Takeaways:
- Secret dual status most seniors don’t know exists
- One program pays your monthly premium automatically
- Hidden plans with low cost and grocery allowances
- Automatic prescription help is worth thousands yearly
- Why millions use this, but you might not know about it
Here’s What Most Seniors Get Wrong About Medicare and Medicaid
Most people think these programs don’t mix, but millions of Americans are getting benefits from BOTH simultaneously.
And here’s the kicker – most eligible people have no idea they qualify for this dual coverage that could transform their healthcare experience.
The Medicare Advantage + Medicaid Combo That Changes Everything
Listen, Medicare Advantage is solid, but it has gaps like copays and no dental coverage. That’s where Medicaid swoops in like a financial superhero.
Medicare Advantage pays first while Medicaid picks up what’s left, eliminating most costs.
This is What People Are Saying About Senior Benefit Services
Senior Benefits has been such a blessing to our family. There are many options to help anyone in any situation, they get confusing at times. Our broker worked and talked us through all the options to find us the best plans with the best prices for our individual needs.” – Nolie Johnson
The Hidden Catches You Need to Know
Let’s be real about the downsides because most D-SNPs are HMOs, which means network restrictions where you need referrals for specialists and can’t just go anywhere for care.
Prior authorization is common, so when your doctor recommends something, the plan might say no, and plan shopping can be confusing because benefits vary wildly between carriers, networks are different in every area, and extra perks come and go.
The Application Strategy That Actually Works
Don’t try to figure this out alone because the system is designed to confuse you, so work with a Medicare specialist who knows D-SNPs inside and out.
They can compare multiple plans, match them to your specific needs, and help you avoid costly mistakes because one wrong choice can cost you thousands while the right choice can save you thousands.
Who Actually Qualifies for This Dual Coverage
Income limits vary by state, but generally modest income levels qualify, and asset limits are typically reasonable amounts that don’t include your home, car, or small life insurance policies.
Your home doesn’t count, your car doesn’t count, and life insurance under certain amounts doesn’t count either.
If you have high medical bills, you might be able to “spend down” to qualify, which means subtracting your medical expenses from your income until you meet the eligibility requirements.
The Real-World Money Impact
Before dual eligibility, people typically face monthly Part B premiums, monthly supplement insurance costs, monthly prescription expenses, and out-of-pocket dental and vision costs.
After dual eligibility, the Part B premium gets covered by Medicaid, D-SNP premiums are often eliminated, prescription costs get dramatically reduced, and enhanced dental and vision coverage becomes available, resulting in substantial monthly and annual savings.
The Application Timeline That Matters
Medicare Advantage enrollment happens from October 15 to December 7 annually, while Medicaid applications can be submitted any time during the year, and D-SNP enrollment has multiple periods throughout the year if you’re dual eligible.
The key strategy is to apply for Medicaid first, then explore D-SNP options once you have both programs in place.
The Biggest Mistake People Make
The biggest mistake is setting it and forgetting it because plans change every year, your health needs change, and better options become available.
You need to review your coverage every fall, compare new plans, and never assume your current plan is still the best option available to you.
The Bottom Line Truth
Can you have Medicare Advantage and Medicaid together? Absolutely, and you should explore this if you think you qualify because the potential savings are massive, the expanded benefits are real, and the peace of mind is priceless.
But you need to be smart about it by getting professional help and staying engaged with annual reviews, because in a healthcare system that loves to keep you confused, knowledge is your best weapon for securing the coverage you deserve.
Frequently Asked Questions
Can I switch from Original Medicare to Medicare Advantage if I have Medicaid?
Yes, dual-eligible individuals get special enrollment periods that others don’t have, allowing you to switch Medicare Advantage plans once per quarter or return to Original Medicare during certain periods.
Will I lose my Medicaid if I join a Medicare Advantage plan?
No way – your Medicaid benefits continue regardless of whether you choose Original Medicare or Medicare Advantage because these programs are designed to work together seamlessly.
Do all Medicare Advantage plans work with Medicaid?
Most do, but D-SNPs are specifically built for dual eligible people and offer better coordination along with usually more extra benefits than regular Medicare Advantage plans.
What happens if I move to another state?
Your Medicare Advantage plan might not be available in your new state, and Medicaid rules differ by state too, so contact both your new state’s Medicaid office and Medicare before moving to understand your options.
Is there a deadline to apply for Medicaid if I already have Medicare Advantage?
Nope – you can apply for Medicaid any time throughout the year, and once approved, the coordination happens automatically with no waiting for special enrollment periods.
What if my income is just over the Meicaid limit?
Don’t give up yet because states have different limits, medical expenses can sometimes be deducted from your income, and some states are way more generous than others, so it’s always worth applying to see what happens.
How often do D-SNP benefits change?
Every single year – plans can change benefits, networks, costs, and extra perks annually, which is why reviewing your plan each fall is critical, even if you love your current coverage.
The reality is that dual eligibility isn’t just about saving money, though the financial benefits can be life-changing for seniors on fixed incomes.
It’s about getting the comprehensive healthcare coverage you’ve earned after decades of hard work, without having to choose between paying for medications and paying for groceries.
If you think you might qualify, don’t let another day pass wondering “what if”. The application process is free, and the worst thing that can happen is they say no, but the best thing that can happen could transform your entire healthcare experience and give you the peace of mind you deserve in your golden years.”
