Medicaid
Written By Jo Gallo 6/23/2025
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What is Medicaid?
Medicaid vs Medicare
Dual-Eligibility Explained
Dual-Eligible Plan Types
Key Points
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Medicaid is a joint federal and state program that helps cover medical costs for people with limited income and resources, with coverage varying significantly by state.
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Medicare focuses on age or disability while Medicaid focuses on income and assets, with Medicare having monthly premiums and larger networks compared to Medicaid's typically no-premium but smaller network structure.
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If you qualify for both Medicare and Medicaid, you become "Dual-Eligible" and gain access to extra benefits and special plan options not available to those with only one program.
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NJ Life and Health does not help with Medicaid applications
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.
About the Author
Jo Gallo is a licensed life and health insurance broker with NJ Life and Health. She has personally helped hundreds of people with their Medicare needs across several states.
She also writes for local senior publications.