Benefits of Dual Eligibility for Medicare and Medicaid

Finding ways to pay for your loved one’s care can be an overwhelming process. Depending on your loved one’s needs, your family might face hospital fees, surgery fees, rehabilitation fees, medical supplies, and more. In order to help afford these costs, your family might rely on services such as Medicaid and Medicare. In some situations, a person may be eligible for both of these services. That can be the case for some people over the age of 65, as well as some people who are under 65 but who have certain disabilities. On this page, I will discuss this dual eligibility.

What is Dual Eligibility?

Qualifying for both Medicare and Medicaid is possible for some people. If a person is dual eligible, they might use a health plan such as Fidelis Dual Advantage. These types of health plans have one point of contact that will organize coverage for both Medicare and Medicaid. This will make it easier to figure out all of the benefits and how to use them.

Three Important Factors

If your loved one is dual eligible, there are a few important factors to consider to help manage their benefits.

First, consider that dual eligibility can help your loved one avoid coverage gaps. Medicare alone might not cover all of the benefits that your loved one needs. This is oftentimes referred to as “gap coverage”. If your loved one has gap coverage, this means that they will have to pay for some services out-of-pocket. One good thing about a dual eligible plan is that it can fill any gaps in coverage, so that your family can avoid these out-of-pocket charges.

In addition, dual eligible plans are available throughout the year, whereas people with just Medicare can only enroll once a year, or during certain life events, such as turning 65. If you have dual eligibility, you can sign up for a year long plan. Alternatively, existing members can select news plans on a quarterly basis.

Finally, dual eligibility allows health support from care managers. A care manager can help to coordinate your loved one’s care. They can assist doctors to work together, so that your loved one can get interdisciplinary care. In addition, they can assist your family in finding other resources in the community to help them recover, and they can help you understand your loved one’s insurance policy.

Getting Help

Navigating your loved one’s insurance policy and making sure that they get the help they need can be difficult. If you need assistance with this process, I am happy to help. In addition, if you need help recovering compensation for your loved one’s injury, please contact my office. I can make sure that your loved one gets the justice that they deserve. I am happy to answer your questions and determine if you can recover any compensation for their situation.

quick guide

Subscribe to our newsletter

Don't miss new updates on your email

Recent Articles