The two quintessential health programs in the United States, Medicare and Medicaid, have their own qualification and eligibility criteria, but many people wonder if they can have both at the same time.
Because health services are expensive in the United States, there are two programs that are essential to cover the most vulnerable sectors of the country: Medicare and Medicaid. After each is totally independent of the other, a common question arises among the population: can I receive coverage from both at the same time?
The short answer is: yes, if you are eligible for both programs, you could be enrolled in both Medicare and Medicaid. But it is just as important to resolve this question as the reasons why, especially so that you don’t allow yourself to have the ability to have both programs.
Medicare and Medicaid are controlled by different government entities. Each has its own eligibility criteria, which allows for the amplification of help to the largest segment of the population that might need it. Individuals covered by Medicare and Medicaid are known as ‘dual eligibles’ and are generally not required to pay any out-of-pocket costs for medical care.
Dual eligibles are believed to represent 20% of Medicare beneficiaries, approximately 12.3 million people.
What are the Medicare and Medicaid eligibility criteria?
Both Medicare and Medicaid qualification requirements and their operation differ from each other in essential respects. First, Medicare is administered at the federal level, and the federal government sets uniform rules for the program across the country. In contrast, individual states administer their own Medicaid provision.
Because they are targeted to different recipients, their requirements are different. Medicare is designed to provide health care, through different coverage plans, such as health insurance, to people age 65 or older or who have disabilities, regardless of their income level.
Medicare has standardized premium costs, but certain claimants may receive deductibles and coinsurance benefits to reduce the price of their coverage. Given the focus of the program, Medicare attempts to provide basic health coverage with physician services, hospital care, and certain medical equipment included in the coverage. Some prescription drugs are covered under Part D.
Medicaid, on the other hand, is more of a form of financial ‘help’ for low-income Americans who might otherwise have difficulty paying for health care coverage. Eligibility requirements are based on the applicant’s earning capacity, regardless of age, and are generally free of charge. All recipients of Social Security supplemental benefits will qualify for Medicaid.
Medicaid is designed to provide comprehensive health care coverage for beneficiaries with basic medical care and long-term care included. Unlike Medicare, Medicaid includes standard costs for prescription drugs, medical equipment, prescription eyeglasses, dental care and other services.
Medicaid coverage is more comprehensive, but there are other factors that affect eligibility and the process can take up to 60 days for an application to be approved. These benefits are for U.S. citizens only, however, children of illegal immigrants may also qualify if they meet certain criteria.