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Are You Qualified? You May Be Eligible!

Understanding Dual eligibility is complex, and we can help. As a wholly independent insurance broker, we can guide you to the best options for you. Just give us a call; we’ll be happy to answer your questions

Below is a guide to dual eligibility:

Differentiating Medicare and Medicaid is difficult. Knowing the difference is important:

Medicare

Medicare is the federal health insurance program for seniors and disabled persons. Medicare Part A is hospital insurance, and Part B is medical insurance. An alternative to Original Medicare (Part A and Part B) is Medicare Part C, otherwise known as Medicare Advantage. The federal government controls original Medicare Part A, and Part B. Medicare Advantage plans are managed by Medicare-approved private insurance companies. With the Medicare Advantage program enrollees receive both Medicare Part A and Part B, and often Part D, which is for prescription drug coverage .

Medicaid

Medicaid is the state and federal medical assistance program for financially needy individuals of any age .

Both programs offer a range of benefits.

What is a Dual Eligible?

Individuals who are enrolled in both Medicaid and Medicare are referred to as dual-eligible beneficiaries, or Medicare dual eligibles, or sometimes simply duals.

Dual-eligibles are enrolled in both programs when a Medicare enrollee’s income and assets are low enough to qualify them for Medicaid help in paying for some of the costs of Medicare – or to qualify them for full coverage under both Medicare and Medicaid.

These enrollees are commonly broken into two groups:

Full-benefit dual-eligibles – who have Medicare but also receive benefits under Medicaid
Partial duals – who have Medicare but qualify to have Medicaid help pay for expenses such as Medicare premiums and/or cost-sharing

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