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What does dual eligibility mean in regards to medicare and medicaid?
"Dual eligibility" means exactly that - eligibility for both Medicare and Medicaid.
If one has a Medicare Advantage plan with New York Medicaid just added, how can the provider collect on the Medicaid portion when it is tied to an inactive Medicare Adv plan, not the current one?
When dealing with a Medicare Advantage (Medicare Adv) plan that has New York Medicaid recently added, and the Medicaid portion is linked to an inactive Medicare Adv plan, there are several steps to consider: Dual-eligible Special Needs Plans (D-SNPs): These are Medicare Advantage Plans specifically designed for individuals enrolled in Medicare and Medicaid. D-SNPs typically require using in-network providers for Medicare services, and these providers should also accept Medicaid. Cost-sharing varies among plans, and some may offer zero cost-sharing for enrollees. D-SNP enrolment is voluntary, and it’s essential to verify that Medicaid covers Medicare cost-sharing, such as deductibles and copayments. Medicaid Advantage Plus (MAP) Plans: For individuals with long-term care needs, MAP plans provide a “wrap-around” partial Medicaid benefit to enhance coordination between Medicare and Medicaid services. If you’re eligible, you can enroll by following these steps: Call 1-800-MEDICARE (633-4227) and enroll in the MAP plan’s Medicare product. You may be instructed to call the MAP insurer directly for further enrollment. Contact New York Medicaid Choice (the state’s managed care enrollment program) at 888-401-6582 to complete the Medicaid portion of enrollment into the MAP plan. Original Medicare + Medicaid: Some individuals may prefer Original Medicare coverage because it provides greater flexibility in choosing providers. In this case, you can combine Original Medicare with a Medicare Part D plan and fee-for-service (FFS) Medicaid. Additionally, consider a Medicaid managed long-term care (MLTC) plan if you have long-term care needs. Remember that each situation is unique, so it’s advisable to consult with a knowledgeable professional or contact your local Medicaid office for personalized guidance.
I am trying to find out about Medicare/Medicaid co-payment responsibility with dual coverage?
Your state may have varying laws about dual coverage, but generally speaking, if you have a primary insurance, they will pay first. Any co-pay or deductible that your primary coverage does not pay will be covered by government insurance.
Can a person have both medicare and Medicaid?
Medicare covers the elderly and people with certain disabilities and end-stage renal disease regardless of income level. Medicaid eligibility is for the poor and is based on low income, family size and a few other requirements. Actually, they can. You only have to be poor and disabled, unable to work..that equals poor. You qualify for both. I know a few people who have both. It is pretty common for people to have Medicaid and Medicare. This is called dual eligible. The above answer is correct in that a person must be elderly or disabled to qualify, and because a disabled person is not eligible to work they more usually qualify for Medicaid. Of course this depends on other income (ie. spousal income), and any assets. Medicare is federal program so the eligibility is the same in every state, Medicaid however is a state program so eligibility will depend on the state your daughter resides in. I used to sell Medicare Advantage plans. My mother has been on both for over 50 years! She became disabled at age 25, and is now going on 76 years old. She has both and also had SSI to boot, but recently became ineligible because she is now in a boarding home.
Which third party plan do dual eligibles receive Medicare prescription drug benefits under?
Medicare Part D
Can you get a discount on medical insurance due to the fact that you receive Medicaid A B by using one as a primary and the other as a secondary?
Do you mean Medicaid (Welfare) Are you referring to getting a Medi-Gap policy to cover what Medi-care doesn't pay? Here's Medicare's 40 page booklet on dual coverage http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf
What are the rules regarding having dual health insurance after retirement?
assuming you mean at age 65 or beyond, medicare becomes the primary insurance, and your other insurance becomes a medicare supplement.
Which third party plan do Dual Eligible receive prescription drug benefits under?
medicare part D
What is Medi-Medi?
People who qualify for both Medicare and full Medi-Cal are known as "dual eligibles" or "Medi-Medis."
Does medicare cover gum disease treatment by a periodontist?
Medicare's dental coverage is limited and typically does not cover routine dental care, such as cleanings, fillings, extractions, or treatment for gum disease. However, there are a few exceptions: Medicare Part A may cover dental services if they are considered medically necessary and are performed in a hospital as part of a larger medical procedure. For example, if you need dental surgery due to a severe infection that affects your overall health, Medicare Part A may provide some coverage. Some Medicare Advantage (Part C) plans offer additional dental coverage as part of their benefits packages. These plans are offered by private insurance companies and may provide coverage for certain dental services, including treatment for gum disease. The specific coverage and costs will vary depending on the plan. Some state Medicaid programs offer dental coverage for low-income individuals, including coverage for gum disease treatment. If you qualify for both Medicare and Medicaid (dual eligibility), you may be able to access dental services through Medicaid. In general, for routine dental care and treatment of gum disease by a periodontist, individuals often need to purchase separate dental insurance or pay for these services out of pocket. It's essential to review your specific Medicare plan or Medicare Advantage plan's benefits to understand what dental services, if any, are covered. Additionally, you can inquire about dental insurance plans that provide coverage for the dental care you need.
What does it mean for a patient to have dual insurance coverage?
This refers to the case in which a patient is insured by more than one insurance plan. For example, a Medicare patient is generally covered for 80% of charges for a physician visit. In this case , he or she would usually be responsible for the remaining 20% of charges. However, if he or she has dual insurance coverage and is also covered by a supplemental plan. Medicare plus, this secondary plan would generally pay the amount not covered by the patient's primary insurance plan, Medicare.
What is the definition of a dual-payer system?
Single-payer and dual-payer refer to the reimbursement source in (for example) the health care system. In a single-payer system, one entity underwrites all the medical bills; in a dual-payer system, two entities share the burden of cost. The terms have recently been used to distinguish a federal government-supported program, similar to to Medicare (single-payer), from one where the cost is shared by the federal and state governments, similar to Medicaid (dual-payer). If someone is complaining about single-payer health care (generally refers to the federal government), they are most likely concerned about taxes, quality of care and access issues. If someone is complaining about dual-payer health care, they are most likely concerned about federal legislation imposing unfunded mandates on the states, or about the states' ability to carry their share of the expenses.
