Medicare + Medicaid Dual Benefits
If you have both Medicare and Medicaid (Medi-Cal in California), you may qualify for more help than you are using today.
Having both programs is called being dual eligible, and it opens doors that neither program opens alone.
What Medi-Medi means. Medicare is your primary coverage and Medicaid steps in behind it. Coordinated correctly, the two together can lower or even remove many of the costs people assume they simply have to pay. Many dual-eligible members qualify for a Dual Special Needs Plan (D-SNP), a Medicare Advantage plan built specifically for people with both programs.
QMB: the Qualified Medicare Beneficiary program. QMB is a Medicare Savings Program based on your income. For those who qualify, it helps pay Medicare premiums and cost sharing, and providers are not allowed to bill QMB members for Medicare deductibles, coinsurance, or copays for covered services. We can help you determine whether your income fits QMB or another Medicare Savings Program, and help you apply.
Chronic conditions get their own plans. Chronic Special Needs Plans (C-SNPs) exist for people managing conditions such as diabetes, heart conditions, ESRD, and others. These plans build their networks, drug formularies, and care coordination around the condition itself.
Wealth does not always disqualify you. Eligibility rules look at specific definitions of income and assets, including structures such as MQTs, and they are not what most people assume. It costs nothing to check, and checking is exactly what our specialty team does.
What a review looks like. We look at what you have, check the programs and plan types you may qualify for, and put the options side by side in plain English. There is never a fee for the review, and you are never obligated to change anything.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Plan availability and program eligibility vary by county and by income; this page is educational and is not financial, legal, or tax advice.