Medicaid and Medicare: You can have both.

Medicaid and Medicare. It’s hard to think of two words that cause as much confusion.

  • What’s the difference between these two government health insurance programs? 
  • What exactly are Medicaid and Medicare? 
  • Who’s eligible to get Medicaid or to get Medicare? 
  • And how can some people get both? 

Read on to find out the answers to these questions and more.

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.

The 4 parts of Medicare.

FYI: Parts A and B are also known as “Original Medicare.”

Part A

Helps pay for hospital stays and inpatient care.

Part B

Helps pay for doctor visits and outpatient care.

Private insurance companies offer other types of Medicare plans with extra benefits that go beyond Original Medicare:

Part C

Combines Part A (hospital insurance) and Part B (medical insurance) in one plan that often includes prescription drug coverage too.

Part D

Prescription drug coverage.

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.

View the "Do I Lose My Medicaid Benefits?" article.

What are dual special needs plans?

Dual health plans are also known as dual special needs plans. They’re offered by private insurance companies, so you can find a dual health plan that best meets your health insurance needs. Being on a dual health plan does not change your Medicaid eligibility or benefits.

See UnitedHealthcare plans in your area.

Please note that the specific benefits dual health plans include can change depending on where you live. Search by your ZIP code to find the right plan to meet your health care needs. 

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