Helping your aging parents get the healthcare they need can be stressful and confusing. This is especially true when dealing with Medicare vs. Medicaid. The good news is that some seniors qualify for both programs at the same time. This is called being “dual eligible,” and it can make healthcare more affordable. Over 12 million Americans benefit from this combined coverage.
This guide covers applying for and managing dual eligibility. You can also click here for part one to learn more about the differences between these two programs.
Medicare vs Medicaid in Kentucky: Applying for Dual Eligibility
How to Apply for Dual Eligibility
Applying for dual eligibility involves two main steps. First, enroll in Medicare, then apply for Medicaid. Here’s how you can guide your senior parents through each step:
Enrolling in Medicare
- Seniors already receiving Social Security benefits are automatically enrolled in Medicare.
- If they are not receiving Social Security, they must apply through the Social Security Administration (SSA).
- Some individuals under 65 may qualify for Medicare due to disabilities. That includes conditions like end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
Applying for Medicaid
- Medicaid bases eligibility on income, assets, and residency.
- Seniors can apply through the Kentucky Cabinet for Health and Family Services (CHFS). Applications can be completed online, by phone, or at a local office.
- The official Medicaid website offers state-specific guidance.
- Gather essential documents beforehand, including proof of income and asset records. You should also include citizenship verification and Medicare enrollment information. This preparation will streamline the application process.
Managing Dual Eligibility
Once your senior parents qualify for both programs, effective management is key to ensuring they receive maximum benefits.
Medicare Advantage and Medicaid
If you are enrolled in a Medicare Advantage (Part C) plan, confirm that it works with Medicaid. Many of these plans offer additional services, such as dental, vision, and hearing care.
Medicare Savings Programs (MSPs)
Kentucky offers MSPs to help low-income seniors cover Medicare premiums, deductibles, and other costs, reducing out-of-pocket expenses significantly.
Care Coordination
Medicare and Medicaid cover different services. Inform healthcare providers of your parents’ dual eligibility to prevent unnecessary charges and ensure seamless care.
Dual-Eligible Special Needs Plans (D-SNPs)
D-SNPs are specialized Medicare Advantage plans tailored for dual-eligible individuals. To qualify, your parents must meet federal Medicare and state-specific Medicaid criteria. Plans like those offered by Wellcare often include added benefits and lower out-of-pocket costs.
Understanding dual eligibility can make a difference if you’re supporting a senior parent. Combining Medicare and Medicaid benefits can help them access affordable, comprehensive healthcare.
Take the time to learn about these programs, explore cost-saving options, and coordinate care. With the right approach, you can ensure your parents receive the care they need while easing the financial burden.
Spring House Senior Living
At Spring House, we understand that finding the right senior living community can be challenging. That’s why we offer a variety of amenities and services to cater to different needs and preferences.
Schedule a tour of one of our communities in Cartersville, Lithia Springs, or Louisville today. You’ll see why Spring House is the ideal choice for senior living.
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