Medicaid and Medicare Dual Eligibility

You can be eligible for both Medicare and Medicaid at the same time. That is called dual eligibility. 

Medicare is health insurance for people over the age of 65 and some younger people with disabilities or health conditions. 

Medicaid is health insurance for people with low income. 

How Do I Become Dual Eligible?

You can become eligible for both Medicare and Medicaid in a few ways.

• You are a Medicaid recipient who becomes eligible for Medicare by turning age 65 or receiving approval for disability benefits from Social Security Administration or the Railroad Retirement Board
• You are a Medicare recipient who qualifies for Medicaid because of low income
• You qualify for both Medicare and Medicaid at the same time

You must enroll in both Medicare and Medicaid to get the benefits available to you as a dually eligible individual. Almost all of your health care costs will be covered if you are dually eligible. 

How Do I Get Medicare Coverage if I am Dual Eligible?

You have the option of enrolling in Original Medicare or a Medicare Advantage Special Needs Plan.

Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). 

A Medicare Advantage Special Needs Plan (also called a D-SNP) bundles Part A and Part B together. Most Medicare Advantage plans also include prescription drug coverage and other health care benefits like hearing, vision and dental. They even provide extra benefits such as over-the-counter drug benefits and transportation assistance. 

Aligning Your Medicare and Medicaid Health Care Coverage

The Arizona Health Care Cost Containment System recommends that dually eligible individuals align their health care coverage to get the best care.

Enrolling in the same health plan for Medicare coverage and Medicaid coverage is called alignment. When your health care coverage is aligned, your health plan can work better to provide the care that you need.  

Have Questions? Learn More from Banner Health. 

Learn more about Banner Health’s Medicare Advantage plans.

Learn about Banner Health’s Medicare Part D plan.

Contact Banner Medicare so we can answer any questions you may have and even help you enroll. 

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