Medicare + Medicaid = Dual Eligible

Older Adults - November 3rd, 2022

Reading Time: 3 Minute/s

Medicare + Medicaid = Dual Eligible

Older Adults

Medicare + Medicaid = Dual Eligible

Posted on November 3rd, 2022 - Reading Time: 3 Minute/s

There is a lot of information out about Medicare right now because the annual enrollment period — the timeframe you can sign up for a Medicare plan or switch from one plan to another — is from October 15 to December 7.

Apple Health and Medicare Cards

When it is time to compare Medicare plans there is a lot of information that can be confusing, especially if your income or circumstances have changed. If you are 65 or older and have a limited income, is there a plan you can afford that will provide enough coverage? What if you’re under 65 but have a disability and a limited income?

Yes. There is one particular kind of Medicare plan called the Dual Plan (D-SNP HMO) that you may qualify for if you meet the eligibility for both Medicare and Medicaid.


What are Medicare and Medicaid? How are they Different and can you be eligible for both?

We talked with Jordan, one of CHPW’s licensed Medicare experts, to answer these questions.

Meet Jordan Wright

Jordan comes to CHPW with 18 years of experience working in the healthcare field. She has a background in nursing, healthcare administration and sales and insurance.

Key takeaway: you may be eligible if you are over 65, or about to turn 65, OR you are under 65 but have certain disabilities AND your income is at or below the Washington Apple standard.

The CHPW Dual Plan provides…

Dual Plan provides enhanced or supplemental benefits, such as:

  • Prescription drug coverage
  • Vision care
  • Preventive and comprehensive dental coverage
  • Fitness resources,
  • Meals delivered after hospital stays
  • rides to medical appointments,
  • and more

Whether you are looking into a Dual Plan or just a Medicare Plan, here are a few terms that are helpful to know as part of your review:

What are the parts of Medicare? What is the advantage of a Medicare Advantage plan?

We talked with Jordan, one of CHPW’s licensed Medicare experts, to answer these questions.

Medicare Parts:

Original Medicare covers two areas of your health care separately: Part A (hospital insurance) and Part B (medical insurance). Part D is optional and includes prescription drug coverage.

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services
Part D adds prescription drug coverage.

Medicare Advantage:

Medicare Advantage Plans are classified as Part C. These plans combine Original Medicare Parts A and B and offer additional benefits, all under one card. Most Medicare Advantage plans also include Part D coverage.

Private insurance companies, like CHPW Medicare Advantage, offer these plans. In addition, they offer extra coverage like dental, vision, hearing and prescription drugs. With an Advantage plan, you have more health care security. You have a fixed copay or coinsurance amounts for things like routine doctor’s visits and also yearly limits on your out-of-pocket health care costs. This means once you pay the maximum limit, you pay nothing more. Original Medicare does not offer these limits. To be eligible for an Advantage Plan, you receive Original Medicare Parts A and B, and continue to pay your Part B premiums.

Learn more

CHPW has additional resources to help find the best plan for you:

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