What do Dual Health Plans offer?

A dual health plan is a type of health insurance designed for people who choose both Medicaid and Medicare. This dual-coverage is also known as dual-special needs plan (D-SNP) or dual-eligible health plan for people 65 or older and under 65 with disabilities.

Can Medicare and Medicaid be combined at the same time?

Medicare & Medicaid is a way to get healthcare based on age and income. Medicare is a federal health insurance program, whereas Medicaid is the US federal government and US state program to provide health benefits for people with limited resources.

Medicaid: Medicaid generally covers pregnant women, children, eligible low-income adults, and individuals with disabilities.

Medicare: National health insurance program that covers seniors and disabled individuals with their healthcare costs. Medicare is divided into four parts to provide more choice and flexibility in their healthcare plan.

• Part A (Hospital Insurance)- Cover hospital stays and inpatient care
• Part B (Medical Insurance)- Cover doctor visits and outpatient care
• Part C- It is a combination of Part A & Part B and also helps pay for prescription drug
• Part D- Pays for prescription drug

Part A & Part B together is called Original Medicare, whereas Part C & Part D are handled by private insurance companies that go beyond Original Medicare.

What is a Dual Health Insurance Plan?

These dual health plans are for people who have both Medicare and Medicaid. Beneficiaries with Medicaid and Medicare at the same time and could also qualify for a dual-health insurance plan based on disability, age, and long-term health conditions. They are a type of Part C Medicare plan.

With this dual-eligibility, the beneficiaries can have all the Medicaid benefits and be eligible for extra- benefits like prescription drugs, hospital stays, and doctor visits.

What is special with Dual Health Plans?

Dual health plan goes beyond Medicaid and Original Medicare, giving extra benefits and features like dental coverage- dental x-rays, fluoride treatments. Other features would be like a routine check-up, cleanings, more hospital and doctors choices, nursing facility, fitness centers membership, eye examination, and credits to buy eyewear, hearing coverage plus credits on hearing aids, chiropractic and acupuncture visits, ride to the pharmacy and health care visits, credits to buy health-related products, foot care visits, personal emergency response system, meals at home at the time of ill-condition, plus many other additional benefits. 

People who qualify for a dual plan can enroll with a $0 plan premium as a bonus. Instead of paying with cash, the patients can spend the credits and buy all sorts of approved health products such as aspirin, OTC medicines, cough drops, denture creams, tablets, toothpaste, toothbrushes, bandages, cleansing wipes, ear, and eye care items, thermometer, blood pressure monitor, first aid supplies, and many more.

Do you miss out on Medicaid benefits while picking a dual health insurance plan?

If you acquire a dual health plan, then your Medicaid benefits will not get impacted. A dual-health insurance plan is a type of Medicare Advantage plan, serving people with special health care needs.

Points to consider in finding the right doctor when you have Medicare and Medicaid

• Decide what is important– Having a doctor who is easily accessible and available when you need, speaks the same language so that you can discuss your specific situation, handles the type of health conditions, specific disabilities. These parameters will help you find the right doctor.
• Identify primary care provider– Primary care providers will get everything set up in terms of preventive care and wellness examination. Your PCP will be the one who will refer you to other specialists in case of specialized care like physical therapy, counseling, et al.
• Your comfort level with the doctor you currently visit– Nothing is more important than your trust in your doctor. If you do not want to change your doctor, check with them if they also take dual health plans and accept new patients.

Dual health plans are a great way to make the most of your insurance coverage. Be very thorough with your research and visit the doctor you are comfortable with so that you make most of the plan.