Medicaid is state-administered health insurance for very low income people.
Some people qualify for both Medicare and Medicaid. These Medicare beneficiaries – called a “Dual Eligible” – pay less or in some cases nothing for their Medicare coverage.
There are three main types of Medicare dually eligible enrollees, each receiving different amounts Medicaid assistance.
QMB: Qualified Medicare Beneficiaries
SLMB: Specified Low-Income Medicare Beneficiaries
QI: Qualifying Individuals
QMBs are dual eligible beneficiaries having the least assets and lowest incomes. They generally pay no Medicare Part A or Part B premiums, no deductibles and no coinsurance.
SLMBs and QIs get help paying their Medicare Part B premiums.
The main benefit of having both Medicare and Medicaid is lower out of pocket health care expenses. Unlike Medicare, state Medicaid programs help pay for:
Long term care such as unskilled personal caregivers in an assisted living setting and the cost of custodial nursing home care.
Mobility and independent living support such as medical alert pendants, meal services, non-medical transportation, medication administration, companionship services and home modifications such as wheelchair ramps.
Medicare out of pocket costs such as Part B medical insurance premiums, Part A hospital insurance deductibles and Part D prescription drug co-pays.
More than 12 million people with Medicare also get financial support from Medicaid, a number that's increased by 1.8 million since 2006.
One in four Medicare-Medicaid enrollees receive only partial Medicaid benefits.
As a group, dual eligible beneficiaries are younger and skew more female than others with Medicare. One third are disabled.
They are also more diverse. Almost half of Medicare-Medicaid recipients belong to a racial or ethnic minority; more than twice the number of Medicare-only enrollees.