Medicare and Medicaid are both government health care programs; however, these programs were designed for different reasons. First, Medicare is available to people that have worked and paid taxes for a certain period of time. The person must also be 65 or older or, they must have a disabling medical condition. In contrast, Medicaid does not require the person to pay any taxes. The Medicaid program was designed for people that have low or no income. This program covers children and adults that meet poverty income guidelines. Coverage under Medicare does not necessarily stop a person from having Medicaid. Also, many people do not know that Medicare will pay for medical bills for some who have Medicaid.
An individual with Medicare can sometimes qualify for Medicaid. This situation is called being a dual eligible. In these cases, the Medicare benefit is often referred to as the Medicare Savings Plan. A person in this category can have Medicare pay for medical bills even though the person has Medicaid. There are limitations on this provision. For example, in some cases, the Medicaid will cover some Medicare premiums and deductibles. In other cases, the person can receive full Medicaid benefits. This means that Medicare will pay for medical bills although the person has Medicaid coverage.
Some people have limitations on their coverage. People that fall into the following categories have limited coverage: Special Low-Income Medicare Beneficiaries, Qualified Medicare Beneficiaries, Qualified Disabled Working Individuals, and Qualifying Individuals. These people can have Medicare pay for medical bills if they have Medicaid, but the coverage by Medicaid is limited. Certain persons referred to as a Qualified Medicare Beneficiary are eligible for Medicare to pay full benefits and Medicaid to pay full benefits. In these cases, Medicare will pay for medical bills
even if the person has Medicaid.
Unfortunately, this dual eligibility does not apply to many people with fixed incomes. The guidelines are strict, and those that do not meet certain poverty standards do not qualify for dual benefits. This situation is a source of frustration for many Medicare beneficiaries.