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Do I need supplemental insurance if I have Medicare and Medicaid?

Do You Need Medicare Supplement Insurance if You Qualify for Medicare and Medicaid? The short answer is no. If you have dual eligibility for Medicare and full Medicaid coverage, most of your health costs are likely covered.

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What is Medicare and Medicaid?

Among government-funded health insurance programs, two to consider for Medicare beneficiaries are Medicare and Medicaid. But what exactly are they, and how do they differ?

Medicare According to the Department of Health and Human Services, Medicare is health insurance for people 65 years of age or older, certain people under 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD). 1 This federal government program has several parts, with the most frequently referenced parts being that of Original Medicare, Part A (inpatient/hospital coverage) and Part B (outpatient/medical coverage). 2 Medicaid Like Medicare, Medicaid is a government program designed to help people pay for their medical costs. The primary difference in qualification being that Medicaid is designed to help pay medical costs for income restricted patients rather than provide coverage for a certain age group, disability, or ESRD.3 Each state has different rules about Medicaid eligibility, unlike Medicare – which is standardized. As such, income qualifications for Medicaid will vary by state.3

What is Medicare Supplement Insurance?

Medicare Supplement Insurance (also known as Medigap), is designed to help work only with Original Medicare.4 Medicare Supplement Insurance, unlike Medicare and Medicaid, is sold by private insurance companies, and helps pay for some of the remaining health care costs Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.4 The main reason people consider a Medicare Supplement Insurance policy comes down to the fact that one’s Original Medicare policy may not cover all health care costs.4 When facing deductibles and coinsurance in Original Medicare, Medicare Supplement Insurance plans can help Medicare beneficiaries cover costs where it’s needed most. Because there are a number of Medicare Supplement Insurance policies available to consumers on Original Medicare, it may be easier to find your metaphorical ‘glass slipper’ when it comes to getting additional coverage – turning your health care experience from a possible nightmare into a Cinderella story.

Do You Need Medicare Supplement Insurance if You Qualify for Medicare and Medicaid?

The short answer is no. If you have dual eligibility for Medicare and full Medicaid coverage, most of your health costs are likely covered.3 As a result, having a Medicare Supplement Insurance plan wouldn’t necessarily be beneficial to you, in fact, an insurance company is not allowed to issue a Medicare Supplement insurance policy to a Medicare beneficiary who receives full Medicaid health coverage! The purpose of Medicare Supplement Insurance is to cover the cost left by deductibles and coinsurance in Original Medicare, but as full Medicaid coverage should cover the majority of those costs, a Medicare Supplement Insurance policy isn’t necessary.3

Find What’s Right for You

A number of factors influence your coverage eligibility and decisions. As such, it’s important to review your existing coverage before making a decision to enroll in any additional coverage options. Having a comprehensive understanding of what your coverage is and what you may need more of will help you make the best decision possible for your unique situation. Your style is your choice. Shouldn't your doctor and your coverage be, too? Coverage of your choice with doctors of your choice are included with plans that don't restrict you to networks of specialists. Learn More

1 Medicare.gov, What’s Medicare, 2020

2 Medicareinteractive.org, Introduction to Medicare, 2020

3 Medicare.gov, Medicaid, 2020

4 Medicare.gov, What’s Medicare Supplement Insurance (Medigap)?, 2020

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How does Oregon calculate SNAP benefits?

SNAP benefit amounts are based on a household's net income: in general $100 more in net income = $30 less in benefits. Households with an elderly or disabled member only have to meet this test if they did not pass the Gross Income test above. All other households do not have to meet this test.

There are three eligibility tests for SNAP: the Gross Income, the Net Income, and the Asset tests. Depending on your state and whether your household has an elderly (over 60) or disabled member, your household may be exempt from the Gross Income, Net Income, and/or Asset tests. Oregon has expanded eligibility beyond the standard federal SNAP eligibility requirements. While the Gross Income and Asset tests are straightforward, Net Income is more difficult to calculate. We recommend using our SNAP Eligibility Calculator to see you're income eligible for SNAP benefits. This information was collected from USDA and state SNAP resources but is not official. This website is not affiliated with any government organization or SNAP/WIC program.

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