The Opportunity for Medicare Advantage Plan Members to Qualify for Medicaid Benefits

More than 10% of Medicare Advantage plan members in most states are currently covered by a managed Medicaid insurance plan, as a “dual eligible” member. However, many additional low-income Medicare Advantage plan members with co-morbid conditions (and high medical costs) could qualify for and be enrolled in a Medicaid program, but have not yet applied for and been certified as eligible to receive benefits under one of Medicaid’s programs.

Securing Medicaid coverage for additional Medicare Advantage members would substantially benefit the insurance companies administering those Medicare Advantage plans, because it would provide additional premium dollars to pay for the services provided to its members.

Securing Medicaid coverage for additional Medicare Advantage members would also substantially benefit those dual eligible members, by providing them with coverage for additional health care, home care, and social services, and by providing financial relief by reducing premiums, deductibles, co-payments and co-insurance.

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