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What is Dual Eligibility? The Benefits of Accessing Both Medicare and Medicaid


Dual eligibility means an individual qualifies for health coverage from both Medicare and Medicaid. If you or someone you know may be dual eligible, reach out to the advisors at RetireMed for local answers to health insurance questions. We look closely at each individual’s situation and can determine if they qualify for certain benefits.

Read further to learn about Medicaid, Medicare, and what it means to be dual eligible.

What is Medicare?

Medicare is also a government-run health insurance program, operated on the federal level. It provides health coverage to individuals ages 65 and older, as well as those with certain qualifying disabilities. Medicare has four parts of coverage: Parts A, B, C, and D.

Check your Medicare eligibility.

Original Medicare: Part A and Part B

Parts A and B are also called Original Medicare. Part A covers hospital services and other inpatient care, while Part B covers medical services and routine outpatient care.

Medicare Part C and Part D

Medicare Part C is also called Medicare Advantage. It expands on the coverage of Original Medicare and includes additional covered services which vary from plan to plan. Part D covers prescription drugs. Medicare Advantage Prescription Drug (MAPD) plans may include drug coverage. Drug coverage can also be purchased as a separate prescription drug plan.

What is Medicaid?

Medicaid is also a government-run health insurance program. More than 80 million people are covered by Medicaid, including eligible low-income adults, children, pregnant women, elderly adults, and individuals with disabilities. While Medicaid is a state program, the federal government’s Centers for Medicare & Medicaid Services (CMS) sets quality standards for how it should be run.

What does “Dual Eligible” mean?

Dual eligible individuals are those who qualify for both Medicare and Medicaid. Dual eligibility includes beneficiaries who are…

  • enrolled in Medicare Part A and/or Part B,
  • receiving full Medicaid benefits, and/or
  • receiving assistance with Medicare premiums or cost sharing.

For dual eligible individuals, Medicare pays first and Medicaid second. Coverage varies from state to state. For local answers to health insurance questions, contact one of our trusted advisors.

RetireMed's team of dedicated advisors can help dual eligible individuals find the right health coverage for their needs and budget. We will look into all available savings programs—such as Extra Help and Medicare Savings Programs—and handle the application and enrollment process.

Get local answers to health insurance questions.

If you or someone you know needs to apply for dual eligible health insurance, our local advisors can help. Call us at 855.999.7981 for no-cost guidance on your health insurance options. You can also schedule a call or share this post with a loved one.