Now Enrolling: Medicare and Medicaid Dual Eligible Plans

Have Medicare & Medicaid? Let’s Simplify

When you have both Medicare and Medicaid you may be entitled to a Dual Eligible Special Needs Plan.

Dual Eligible Special Needs Plans can offer additional comprehensive coverage that goes above and beyond just Medicare alone such as Care Coordination, Dental Coverage, and Transportation, as well as Extra Help Benefits.

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or call 888-410-4987 to speak to a Licensed Agent

A Few Benefits of Extra Help

Extra Help amount and benefits depend on income and resources. Most beneficiaries can receive either a full-subsidy or a partial-subsidy that include

No Premiums

No Deductibles

(unless receiving the partial subsidy)

Lowered Prescription Drugs Costs

As Low as $3.60 for Generic and No More Than $8.95 in 2020 for Prescription Drugs

Care Coordination

Vision & Hearing Benefits

Over-the-counter (OVTC) Quarterly Benefits

Transportation Benefits

Wellness Programs

Covering Gym Memberships, SilverSneakers®, Fitness Programs or Acupuncture

Covers Hospital Services

Do you qualify for Extra Help?

Both Medicaid and Medicare (dual eligible) people are often automatically eligible for Extra Help assistance. Others who automatically qualify also include those receiving Medicare Savings Programs and Supplemental Security Income (SSI).

Anyone not enrolled in any of the above programs can still receive Extra Help benefits if they meet the income and assets requirements for 2020 eligibility. For individuals, this means that your annual income is less than $18,735 and your assets are less than $14,390. For married couples, this means that your annual income is less than $25,365, and your assets are less than $28,720.

*Even though these individuals automatically qualify for Extra Help programs, it is still a best practice to seek consultation from benefits counselors to examine all the benefits of a dual eligible special needs plan. 

Beneficiaries that receive Extra Help can also get the following protections:

  • A quarterly Special Enrollment Period (one time every three months between January – September + once during Annual Open Enrollment) to join or switch Medicare Part D drug plans during the year. These opportunities allow people who get Extra Help to not wait for the Annual Open Enrollment Period (Oct. 15 – Dec. 7) to change plans. Any plan changes made outside the Annual Open Enrollment Period will become valid for the following month. This is especially helpful to seniors/adults with disabilities who may need to begin medications that are not on their current plan’s formulary (approved drug list).
  • No Part D late enrollment penalty, even if the beneficiary enrolls late. Meaning protections extend to after they were first eligible to join a Part D plan and if they did not have other drug coverage.

Request a Free Consultation

Call a licensed insurance agent

888-410-4987

© Copyright - Medicare Advantage Simplified

This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments and restrictions may apply. Benefits, premiums and/or copayments or coinsurance may change on January 1 of each year.

medicareadvantagesimplified.com is a website owned and operated by Highland Health Direct, LLC dba American Retirement Benefits. Highland Health Direct, LLC is a licensed representative of a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Highland Health Direct is a licensed representative of a Medicare Supplement Plan. Enrollment in any plan depends on contract renewal.

Highland Health Direct, LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

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