How Does Medicare And Medicaid Work Together?

How Does Medicare And Medicaid Work Together?

Medicare (Part A and Part B) and Medicaid are two different programs. These programs are run by different government agencies. Medicare helps cover medical services for disabled or aged Americans. Medicaid helps cover medical services for low-income Americans. Medicare and Medicaid have different rules and requirements.

Medicare covers most medical expenses for those 65 or older and many disabled people of any age. Medicare has four parts. Medicare Part A and Part B are for hospital and medical coverage. Medicare Part C is for prescription drug coverage. Medicare Part D is for drug coverage if you already have Medicare.

Medicaid is a low-cost health insurance program for lower-income people and some others, such as children, pregnant women, and people with disabilities.

Medicare and Medicaid work together in a few different ways. Some people qualify for both Medicaid and Medicare. Many people who qualify for Medicaid have low incomes and cannot afford to pay deductibles, co-pays, and other costs. Medicaid helps cover these costs.

Medicare does not cover everything, so for some things you may also qualify for Medicaid. Medicaid helps pay for things that Medicare does not cover, such as the cost of a nursing home, a long-term care hospital stay, and some prescription drugs. Medicaid does not pay for long-term care in nursing homes if you are not eligible for Medicare. Medicaid helps pay for long-term care if you are eligible for Medicare.

Medicare also helps pay for some health insurance if you get Medicaid.

What if I qualify for both Medicaid and Medicare?

You may qualify for both Medicaid and Medicare. If you qualify for both, you will:

pay no premiums for Medicare Part A and Part B

pay no deductibles for Medicare Part B and Part D

pay limited co-payments for Part A and Part B

If you qualify for both Medicaid and Medicare, you may also be able to receive some prescription drug coverage through Medicare Part D. Medicare Part D helps pay for prescription drugs, but it does not cover all drugs. Medicaid helps pay for some prescription drugs. If you qualify for both Medicaid and Medicare, you will pay reduced co-payments for your prescription drugs.

Medicare Part B and Part D help pay for covered drug costs. The Medicaid program pays the remaining amount. In most cases, you will pay a $1 co-payment for each prescription. In some cases, you may pay no co-payment (for example, for generic drugs and for drugs paid for by Medicaid).

If you qualify for both Medicare and Medicaid, you do not pay any premiums for Part B or Part D. However, you may have to pay a deductible for Medicare Part B. Medicare Part B helps pay for some of your costs if you go to the doctor or have tests in the hospital.

If you have Medicaid and Medicare Part D, you must meet state-specific deductible amounts. If you have Medicaid and Medicare Part D, you may have to pay a premium to enroll in Medicare Part D, and you cannot enroll in a Medicare Part D plan before your Medicaid coverage ends.

What if I have both Medicare and Medicaid?

Many people with disabilities are eligible for Medicaid and Medicare. If your income and assets are low, you may qualify for Medicaid and Medicare. If you are eligible for both Medicaid and Medicare:

Medicaid helps pay for some medical services the Medicare does not cover. Medicaid helps pay for long-term care or nursing home care. Medicaid helps pay for some drugs and medical equipment. Medicaid helps pay for some medical services if you have certain disabilities.

Medicare helps pay for some medical services Medicaid does not cover. Medicare helps pay for doctors' services, hospital care, medical equipment, and medical supplies. If you are over 65, Medicare helps pay for hospital and medical costs. Medicare helps pay for drugs and medical services if you have certain disabilities.

If you qualify for both Medicaid and Medicare, Medicaid pays first. Medicare pays second. Medicare may pay more than Medicaid if you have resources over a certain amount (the limit is $8,394 for an individual and $16,420 for a couple).

The Part D coverage provided by Medicare Part D may cover some of your costs. The Medicaid program pays the remaining amount.

If you have Medicare and Medicaid, you will pay no premiums for Medicare Part A.

If you have Medicare and Medicaid, you will pay no deductibles for Medicare Part B. You may have to pay a deductible for Medicare Part D.

If you have Medicare and Medicaid, you will pay limited co-payments for Medicare Part A and Part B. You may have to pay an additional co-payment for Medicare.

If you have Medicaid and Medicare, you may have to pay a premium to enroll in Medicare Part D.

If you have Medicaid and Medicare, you may have to pay a co-payment for Medicare Part B.

If you have Medicaid and Medicare, you may have to pay a co-payment for Medicare Part D.

If you have Medicaid and Medicare, you may be able to get some prescription drug coverage through Medicare Part D.

If you have both Medicaid and Medicare, your medication coverage may come from both Medicaid and Medicare. If you have both Medicaid and Medicare, you may have to pay a co-payment for your medications. Medicare Part D helps pay for some prescription drugs. Medicaid helps pay for some prescription drugs.

Source: Medicare.gov

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