The short answer
Some people qualify for both Medicare and Medicaid, called dual eligibility. When you have both, Medicare pays first and Medicaid can help cover costs Medicare leaves, such as premiums, deductibles, and coinsurance. This can greatly lower what you pay for cancer care.
People who qualify for both Medicare and Medicaid are called dually eligible.
Medicare pays first, and Medicaid can help with costs Medicare does not cover.
Medicaid may help pay Medicare premiums, deductibles, and coinsurance for those who qualify.
Dual eligibility can greatly reduce out-of-pocket costs for cancer care.
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The full explanation.
The simple version
Some people qualify for both Medicare and Medicaid at the same time. This is called being dually eligible. When you have both, the two programs work together to cover more of your care and lower what you pay — which can make a big difference for cancer treatment.
How they work together
When you are dually eligible, Medicare pays first for covered services. Then Medicaid can help pay costs Medicare leaves behind, such as deductibles and the 20% coinsurance, and may cover some services Medicare does not, like certain long-term care.
Medicare pays first, and Medicaid can fill in many of the gaps.
Help with premiums and drugs
For people who qualify, Medicaid or a Medicare Savings Program may help pay Medicare premiums, deductibles, and coinsurance. Many dually eligible people also get Extra Help, which lowers Medicare Part D prescription drug costs.
Why it matters for cancer
Cancer care can be costly. Having both programs can greatly reduce out-of-pocket costs for hospital care, chemotherapy, radiation, and drugs. A hospital social worker or financial counselor can help you find out if you qualify and apply.
Words to know
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Common questions
▸What does 'dually eligible' mean?
It means you qualify for both Medicare and Medicaid at the same time. This often applies to older adults or people with disabilities who also have limited income and resources.
▸How do the two programs work together?
Medicare pays first for covered services. Then Medicaid can help pay costs Medicare leaves, such as deductibles and the 20% coinsurance, and may cover some services Medicare does not.
▸Can Medicaid pay my Medicare premiums?
For people who qualify, Medicaid or a Medicare Savings Program may help pay Medicare premiums, deductibles, and coinsurance, lowering your out-of-pocket costs.
▸Why does this matter for cancer care?
Cancer treatment can be expensive. Having both programs can greatly reduce what you pay for hospital care, chemo, radiation, and drugs, since Medicaid can fill in many of Medicare's gaps.
▸What is Extra Help?
Extra Help is a program that lowers the cost of Medicare Part D prescription drugs for people with limited income. Many dually eligible people qualify for it automatically.
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