What the plans are
People who have both Medicare and Medicaid can still choose Original Medicare or a Medicare Advantage plan. Medicare lists plans made for dual eligibles because they are meant to make services easier to get, include Medicare drug coverage and sometimes cost less.
- Special Needs Plans (D-SNPs) are Medicare Advantage plans for people with both Medicare and Medicaid.
- Medicare-Medicaid Plans combine both programs and are only available in certain states.
- The Program of All-Inclusive Care for the Elderly (PACE) can help certain people get care outside of a nursing home.
Things worth checking
A plan built for people with Medicaid is still a plan with a network. A few questions can save trouble later.
- Are your doctors, specialists and pharmacy in the plan's network?
- How are your Medicaid services, such as transportation or personal care, handled?
- Which extras are included, and do they require a condition or a certain Medicaid level?
- Does the plan need approval before certain services?
How it compares with Original Medicare
With Original Medicare and Medicaid, you can generally see any doctor who accepts Medicare, and Medicaid helps with cost sharing. A dual plan can bundle services and extras into one plan, but you trade some choice of doctors for that. Neither is right for everyone, and the answer depends on who you see and what you need.
Changing plans
People with Medicaid or Extra Help may have more chances to change plans than others, so ask before assuming you have to wait for open enrollment. Medicare open enrollment runs October 15 to December 7, and changes start January 1.