Navigating the healthcare system can be challenging, and for the more than nine million people who are eligible for both Medicare and Medicaid, it can be especially difficult. Medicare and Medicaid are different programs. And people who are eligible for both, known as “dual eligibles,” must understand the differences in eligibility requirements and coverage details.
The 262,000 dual eligibles in Georgia should take the following steps to help simplify their healthcare experience and get the best care available.
1. Understand the differences between Medicare and Medicaid.
Medicare provides services such as physician visits, hospital stays and prescription drug costs to people 65 and older and disabled individuals.
Medicaid is managed by the state government, and pays for most long-term care as well as Medicare deductibles, co-payments and other health care costs that beneficiaries would otherwise pay for out of pocket.
2. Explore options that provide support for dual eligibles.
Medicare Advantage special-needs plans address the challenge of coordinating benefits between Medicare and Medicaid beneficiaries. Offered by private companies, these plans can be chosen in place of Medicare. Special-needs plans support dual-eligible individuals by serving as a single entity that coordinates all aspects of care, such as in-home visits, social support services and help when transitioning home from the hospital.
3. Take advantage of free community resources
For more information on Medicare and the Georgia Medicaid program, residents may contact 1-800-MEDICARE, 1-877-486-2048 or 1-800-766-4456. To contact the State Health Insurance Assistance Program office in Georgia, call 1-800-669-8387.
Community Outreach Manager, Care Improvement Plus, Buckhead