Can You be Enrolled in Both Medicare Advantage and Medicaid?

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 08/29/2018

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People who are eligible for both Medicare and Medicaid are sometimes referred to as “dual eligible.” You might be able to sign up for a Medicare Advantage plan while you’re receiving Medicaid benefits.

What’s the difference between Medicare and Medicaid?

Medicare is a federal government health insurance program for qualified people 65 years old and above, or those who qualify by disability. Medicaid is a government program paid for by both state and federal government funds. Eligible people with disabilities or low incomes may get health coverage through Medicaid.

What’s Medicare Advantage?

Medicare Advantage, also called Medicare Part C, gives you an alternative way to get your Original Medicare (Part A and Part B) benefits through a private, Medicare-approved insurance company. Besides providing your Part A and Part B benefits, most Medicare Advantage plans also include prescription drug coverage – and many plans offer extra benefits as well. Some examples might include membership in fitness programs and/or routine vision care.

Now let’s move on to the question of getting Medicare Advantage and Medicaid at the same time.

Medicare Advantage and Medicaid

You may be able to enroll in a Medicare Advantage plan when you’re on Medicaid. For example, there’s a type of Medicare Advantage plan called a Special Needs Plan, or SNP.

Special Needs Plans are geared for people in specific situations. One type of SNP is specifically for dual eligibles – people eligible for both Medicare and Medicaid. Please note:

  • Medicare SNPs cover the same services and supplies that all Medicare Advantage plans are required to cover.
  • Make sure your doctor accepts Medicaid to make sure you’re covered. Of course, the doctor must also accept Medicare assignment. Your Medicare Advantage plan should be able to help you find doctors who accept both.
  • You need to be enrolled in both Medicare Part A and Part B to qualify for a Medicare Advantage plan. You must also live within the plan’s service area.
  • With any kind of Medicare Advantage plan, in most cases you must continue paying your Medicare Part B premium. However, the Medicaid program might pay your premium.

Where can I find a Medicare Advantage plan when I’m on Medicaid?

Generally, it may be best to check with insurance companies that offer Medicare Advantage plans in your area to see if they offer “Dual-Eligible SNPs” or any Medicare Advantage plans that you may be eligible for while you’re on Medicaid.

If you need help finding a Medicare Advantage plan when you’re on Medicaid, I can help you. Use the links below to arrange a phone call with me or have me email you customized information. You can compare Medicare Advantage plans right away by clicking the Find Plans button on this page.

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