Here are a few examples of how Medicaid can work with Medicare.
- Medicaid can provide secondary insurance: For services covered by Medicare and Medicaid (such as doctors’ visits, hospital care, home care, and skilled nursing facility care), Medicare is the primary payer. Medicaid is the payer of last resort, meaning it always pays last. When you visit a provider or facility that takes both forms of insurance, Medicare will pay first and Medicaid may cover your Medicare cost-sharing, including coinsurances and copays.
- Medicaid can provide premium assistance: In many cases, if you have Medicare and Medicaid, you will automatically be enrolled in a Medicare Savings Program (MSP). MSPs pay your Medicare Part B premium, and may offer additional assistance.
- Medicaid can provide cost-sharing assistance: Depending on your income, you may qualify for the Qualified Medicare Beneficiary (QMB) MSP. If you are enrolled in QMB, you do not pay Medicare cost-sharing, which includes deductibles, coinsurances, and copays.
- Medicaid can provide prescription drug assistance: Dually eligible individuals are automatically enrolled in the Extra Help program to help with their prescription drug costs.
- Medicaid can offer care coordination: Some states require certain Medicaid beneficiaries to enroll in Medicaid private health plans, also known as Medicaid Managed Care (MMC) plans. These plans may offer optional enrollment into a Medicare Advantage Plan designed to better coordinate Medicare and Medicaid benefits. Note: You cannot be required to enroll in a Medicare Advantage Plan.
Make sure to call 1-800-MEDICARE or contact your local Medicaid office to learn more about Medicare and Medicaid costs and coverage, especially if you are a dual-eligible.
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Get Help Applying for Medicare Cost-Savings Programs
If you live in New York, the Medicare Rights Center can help you enroll in various Medicare cost-savings programs. Please answer a few questions to see if we can connect you with a trained benefits enrollment counselor.
Contact your local State Health Insurance Assistance Program
Each state offers a SHIP, partly funded by the federal government, to give you free counseling and assistance. A SHIP counselor may be available by phone or in person.
Visit www.shiptacenter.org to find your local SHIP office.
Contact your local State Health Insurance Assistance Program
Based on the information you provided, you do not appear to be eligible for Medicare cost-saving programs.
Each state offers a State Health Insurance Assistance Program (SHIP), partly funded by the federal government, to give you free counseling and assistance. A SHIP counselor may be available by phone or in person.
Visit www.shiptacenter.org to find your local SHIP office.
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A trained counselor from the Medicare Rights Center will be in touch in the next 3-5 business days to discuss your options.
Click here to learn more about the various Medicare cost-savings programs.
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