SENIORS
Medicare & Medicaid
How two plans work together to provide complete coverage.
Whereas Medicare beneficiaries typically qualify based on ageIndividuals age 65 and older qualify for Medicare. While individuals who have a disability for 24 months or longer may also qualify., Medicaid beneficiaries qualify based on income.
When individuals have both Medicare and Medicaid, it is often referred to have having dual enrollment.
Benefits of Having Both
Dual plans offer extra benefits at no extra cost.
Dual plans go beyond either Medicaid or Original Medicare alone. You’ll still keep the Medicaid benefits you get today. And better yet, with a dual plan, you could get many extra benefits and features than Original Medicare at no extra cost. These extra benefits may include:
- Dental care, plus credit for restorative work.
- Eye exams, plus credit for eyewear.
- Hearing exams, plus credit for hearing devices.
- Rides to health care visits and the pharmacy.
- Credits to buy hundreds of health-related products.
As an added bonus, people who are dual eligible can usually enroll for no monthly premium.
Election Periods
Being Dual eligible allows individuals additional election periods, other than the Initial Election Period (IEP), Annual Election Period (AEP), and the Open Enrollment Period (OEP).
These additional election periods come in the form of being able to enroll or dis-enroll once per calendar quarter, January through September.
| What You May Have Now | What You Could Have | |
|---|---|---|
| Medicaid benefits | ✓ | ✓ |
| Hospital Stays | ✓ | ✓ |
| Doctor and outpatient care | ✓ | ✓ |
| Prescription drugs | ✓ | ✓ |
| More choice of doctors | ✓ | |
| More hospital choices | ✓ | |
| Additional prescription drug coverage | ✓ | |
| Additional benefits | ✓ |
Tip
It can be a good idea to review your Medicare Prescription Drug Plan coverage every year, to see if your plan covers the medications you need now and may need in the upcoming year.
Frequently Asked Questions
What's the difference between Medicaid and Medicare?
What does dual eligible mean?
Who can qualify for Medicaid?
How can I enroll in Medicaid?
To apply for Medicaid, you’ll need to submit an application to the agency that manages the Medicaid program in your state. In the state of Texas the first website to reference is: YourTexasBenefits.com, where you can apply online for Medicaid benefits.
What do I need to apply for Medicaid?
When you apply for Medicaid, you’ll need to fill out an application form. Different states have different requirements for Medicaid. You’ll likely need to have various documents, such as:
Personal information
- Information about household members (name, date of birth, and Social Security number)
- Proof of citizenship
- Financial information
Rent or mortgage information
- Expenses (utilities, daycare, etc.)
- Vehicle information
- Bank statements
- Income (pay stubs)
Medical information
- Proof of disability or medical records showing a lasting medical condition
- Recent medical bills
Plans Focused on Preventative
Many of these Medicare Advantage plans have preventative coverage and add-ons that are preventative focused.