Medicaid
Jo Gallo
Licensed Life and
Health Insurance Broker
Written 5/26/2023
Medicaid
Intro | Should I Take Medicare Now?
|How To Signup For Medicare | Medicare Secondary Options |
I'm Turning 65 But My Spouse Is Not |
Medicare Disability | Medicaid
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What is Medicaid?
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. Medicaid coverage and enrollment guidelines vary heavily state to state. In New Jersey, Medicaid is known as NJ Family Care.
Medicare vs. Medicaid
Medicare is a federal health insurance program for individuals that are 65 and older, have been on disability for more than 24 months, or have ESRD or ALS. It is run at the federal level and is more focused on age or disability. Medicaid is a joint federal and state program that is most often administered at the state level. It focuses more on income and assets than age.
Medicare has a monthly premium and a robust network. There are also out of pocket costs that can be alleviated and extra benefits that can be added with Medicare secondary plans. Medicaid often has no monthly premium and has little to nothing in the way of out-of-pocket costs for the enrollee. The tradeoff is Medicaid often has a smaller network compared to Medicare and private insurance. These are general guidelines, as Medicaid benefits vary greatly from state to state.
Dual Eligibility
If you are eligible for both Medicare and Medicaid, you may be Dual-Eligible. Dual Eligible individuals are often given extra benefits and Medicare secondary plan options. Medicaid may help pay your Medicare premiums, and you may be eligible for “Dual-Eligible” plans. These are Medicare plans that may give extra benefits Original Medicare doesn’t offer such as Dental and Vision, Care Managers, Grocery Benefits, and more!
D-SNP, I-SNP and more!
Dual Eligible plans may be available in your area. The most common type is a D-SNP (Dual Eligible Special Needs Plan). There could be other Dual Eligible plans available depending on your location that help cover specific situations. These include I-SNPs (Institutional Special Needs Plans) and C-SNPs (Chronic Condition Special Needs Plans).
When you turn 65, you are given a new Initial Enrollment Period. This allows you to switch your Medicare Supplement plan or carrier, or switch to a Supplement if you have been in the Medicare Advantage plan.