Dallas County Dual-Eligible Medicare Plans

Dallas County Dual Eligible Medicare and Medicaid Plans 

Medicare beneficiaries who are also eligible for Medicaid are considered dual-eligible. If you are Medicare dual eligible, you may qualify for a Medicare D-SNP (Dual Special Needs Plan), which is a type of Medicare Advantage plan.

Beneficiaries who are eligible for this combination of coverage are sometimes called Medicare dual eligible.

If you are dual-eligible for Medicare and Medicaid, you may qualify for a special type of Medicare Advantage (Part C) plan called a Medicare Dual-Eligible Special Needs Plan (D-SNP).

Can you have Medicare and Medicaid at the same time?

Medicare and Medicaid are both public health insurance programs. If you are dual-eligible, you can have both Medicare and Medicaid coverage at the same time.

Two of the key differences between Medicare vs. Medicaid includes:

• Medicare is for people age 65 and over and for certain people under 65 who have a qualifying disability. Medicare eligibility is consistent for everyone across the U.S., no matter what state you live in.
• Medicaid is for people of any age who meet certain income qualifications. Medicaid is administered by state governments, and eligibility requirements can differ between states.

Who is dual-eligible for Medicare and Medicaid?

To be Medicare dual eligible, you have to meet the requirements for Medicare and your state’s Medicaid program.

To be eligible for Medicare, you must:

• Be at least 65 years old or have a qualifying disability
• Be a U.S. citizen or permanent legal resident
• Be eligible for benefits through Social Security or the Railroad Retirement Board

Generally speaking, Medicaid provides health insurance to low-income individuals and families, children, and pregnant women. The best way to find out if you are eligible for Medicaid is to visit your state’s Medicaid website.

If you’re eligible for Medicaid and want to find out if you’re also eligible for a dual-eligible Medicare Medicaid plan, you can call and speak with an Ashford Insurance licensed insurance agent to find out if you are eligible. An agent can help you compare the plans that are available where you live and find out what they may cover, which could include benefits like prescription drugs and other services.

Medicare Dual Eligible Special Needs Plans (D-SNPs)

Another type of coverage that may be available to dual-eligible beneficiaries (depending on where you live) is a Medicare Dual Eligible Special Needs Plan (D-SNP).

A Medicare special needs plan is a certain type of Medicare Advantage plan that is designed for people with specific health conditions or circumstances.

A D-SNP is built for the specific needs of dual eligibles. All Medicare SNPs (including Medicare D-SNPs) provide prescription drug coverage.

How do Medicare and Medicaid work together?

For dual-eligible beneficiaries, Medicare serves as the primary payer, and Medicaid acts as the secondary payer.

That means Medicare is the first to pay for covered services and items, and then Medicaid will help pay some or all your remaining costs.