Senior Educators: Medicaid & Medicare

Some individuals are fortunate enough to be covered by both Medicare and Medicaid. For such “dual eligibles,” the out-of-pocket expenses are quite low. And, in many cases, there is no need for any insurance other than a standalone drug plan. But, recently, new Medicare Advantage plan options have been created specifically designed for those receiving both Medicare and Medicaid.

What if I have a share of cost before Medicaid pays anything?

In your case, a regular Medicare Advantage plan may help you save money and get extra services. For example, if you have a $500 share of cost each month, with traditional Medicare you would pay $124 to see a doctor and the first $500 of the hospital co-pay. In some cases, Medicare Advantage plans may offer you better protection or cost savings.

What are the benefits of a Medicare Advantage plan for dual eligibles?

Because the costs associated with traditional Medicare services are quite low for full dual eligibles, there is very little savings from signing up for a standard Medicare Advantage (MA) plan. The so-called Special Needs Plans (SNPs) and certain other MA plans, however, have been designed with additional benefits that go beyond traditional Medicare and Medicaid. Some examples of additional benefits include dental, vision, hearing, and over-the-counter medications and supplies. In addition, in certain places, dual eligibles choose SNPs because the provider network is broader than the Medicaid network.

Where does Senior Educators Insurance Services fit in?

Many people like help deciding which plan is a good choice for them. Plans vary widely from company to company and from place to place, and when comparing plans between companies it’s important to compare the fine print—not just the premiums. That’s what Senior Educators Insurance Services was created for—to provide free, unbiased assistance to Medicare recipients to help them choose appropriate coverage. To request help now, please fill out the short informational form here so a licensed representative can be well informed about your healthcare preferences. Or simply give us a call at 1-800-505-8575 and speak with a trained and licensed representative now!

If you prefer to do the research by yourself, we’ve created a number of tools to help you do so. First, we have created the Senior Educators Insurance Services’ Top 10 Tips for Navigating Medicare, which captures a very high-level perspective on what to consider based on our years of experience. Second, we have created a plan comparison engine that shows you a list of the plans available in your area. To access that tool, enter your zip code on the side of this page and click the “Find Plans” button. We hope that if you find a plan through our tools, you’ll enroll through our organization, as it’s how we can afford to provide excellent, unbiased information and help.