The National Consumer Protection Technical Resource Center: The Center of Service & Information for SMPs

Health Care Fraud

Medicaid Basics

Medicaid is a joint Federal and state program that helps pay medical costs for some people with limited income and resources.   Some people qualify for both Medicare and Medicaid. These people are called “dual-eligibles.”

  • Most of your health care costs are covered if a person has Medicare and Medicaid.
  • Medicaid programs vary from state to state. They may also be called by different names, such as “Medical Assistance” or “Medi-Cal.”
  • People with Medicaid may get coverage for services that aren’t fully covered by Medicare, such as nursing home and home health care.
  • The income limits for Medicaid vary from state to state.
  • The State Medical Assistance (Medicaid) office is responsible for determining eligibility and enrollment.

Medicare Savings Programs

Help from Medicaid to Pay Medicare Premiums

States have programs for people with limited income and resources.   These programs pay Medicare premiums and, in some cases, may also pay Medicare Part A and Part B deductibles and coinsurance.   These programs help millions of people with Medicare save money each year.

To qualify for a Medicare Savings Program, you must meet these conditions:

  • Have Medicare Part A
  • Be an individual with limited resources set annually be Medicare. Resources include money in a checking or savings account, stocks, and bonds. Resources don’t include your home, car, burial plot, up to a set amount for burial expenses, furniture, or other household items.
  • Be an individual or a married couple with a monthly income less than the threshold set by Medicare.
  • The State Medical Assistance (Medicaid) office is responsible for determining eligibility and enrollment.

Note: Individual states may have different income and/or resource limits. Income limits will increase slightly each year or if you have other dependents in your household.

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