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Can I have Medicare and Medicaid at the same time?

There are two main healthcare programmes offered to Americans who may otherwise struggle to get insurance coverage, but they are organised in very different ways.

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Medicare and Medicaid aim to provide affordable healthcare coverage for Americans who may be vulnerable or who would otherwise struggle to get insurance. There are different healthcare plans that fall under the umbrella of each programme, but Medicare and Medicaid are completely separate and are controlled by different entities.

In some instances, it is possible to be enrolled in both Medicare and Medicaid at the same time. Individuals covered by both Medicare and Medicaid are known as ‘dual eligibles’ and typically are not required to pay any out-of-pocket costs for the healthcare.

Dual eligibles are thought to account for 20% of Medicare beneficiaries, roughly 12.3 million people.

What are the differences between Medicare and Medicaid?

While the two programmes both offer health coverage they differ in a number of key ways. Firstly the administration of Medicare is done at a federal level with the federal government establishing uniform rules for the programme across the nation. In contrast, individual states manage their own Medicaid provision.

They target different types of recipient too, with very different eligibility requirements. Medicare is designed to do exactly that; provide ‘care’ for those aged 65 or older or who have disabilities, regardless of their income level.

Medicare has standardised premium costs, but certain claimants can receive deductibles and coinsurance benefits to reduce their price of their coverage. Given the programme’s focus, Medicare attempts to offer basic healthcare coverage with medical services, hospital care and certain medical equipment included in the coverage. Some prescriptions drugs are covered under Part D.

In contrast, Medicaid is more like a form of financial ‘aid’ for low-income Americans who may otherwise struggle to afford healthcare coverage. The eligibility requirements are based on income requirements, regardless of age, and they are generally free. All recipients of Social Security supplemental benefits will qualify for Medicaid.

Medicaid is designed to provide all-round healthcare coverage for beneficiaries with basic healthcare and long-term care provision included. Unlike Medicare, Medicaid includes as standard prescription drug costs, medical equipment, prescription eyeglasses, dental care and other services.

The coverage for Medicaid is more comprehensive but there are other factors affecting eligibility and the process can take up to 60 days for an application to be approved. These benefits are only for American citizens, however the children of illegal immigrant can also qualify if they satisfy certain criteria.