If you have Medicare and a supplemental insurance, can you receive Medicaid also? - AgingCare.com

If you have Medicare and a supplemental insurance, can you receive Medicaid also?


Or will lose both medicare and the other insurance? Can't afford assisted living. If qualify for Medicaid, will state take social security and pension funds? If so, does that mean you no longer have medicare or your supplemental insurance coverage? The supplemental coverage payment is deducted from the pension.

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Thanks for your response Igloo, a very clear explanation. In my household we are likely to eventually share your mom's scenario...SS, federal pension (me), Medicare and BCBS, wirh a spouse who may eventually need Medicaid to cover NH. At that point I'll have to change my BCBS to just cover me instead of both of us.
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Vegas - nice visual analogy!

Medicare, Medicaid & SS are all entitlements:
Medicare is a general entitlement that provides for health insurance for those over 65. We all pay into Medicare through whatever FICA is taken out of our employment checks. You apply for Medicare when you turn 65. When we retire and start to receive SS, Medicare is still taken out of the SS check and right now is about $ 98 a month. Medicare is 100% federal.

SS is a earnings based entitlement. How much you get is based on your or your spouses earnings over their lifetime.

Medicaid is an "at-need" entitlement. For NH Medicaid, the rules are pretty limited to those individuals who are really at impoverishment point. In general, it's about 2K in non-exempt assets & 2K in income & show to be "at-need" for skilled nursing care. Now some states have a Medicaid diversion program which will pay for AL but most Medicaid is for those in a NH. The actual $ amounts allowed under Medicaid is set by the states as the states administer Medicaid BUT under a general Federal guideline (as funds are both state & federal). Like when I applied for my mom, the income ceiling was $ 2,094.00 a month for Medicaid in TX.

Now you can get Medicaid for health care services as well as having Medicare. They co-exist well together & about 60% of all NH residents do both. But for the supplemental insurance continuing, it will depend on how the policy reads. My dad was a fed and so both he & mom were on a extremely good high option Blue Cross Policy. Monthly coverage payment was deducted from mom's federal spouse pension. When mom went into a NH and applied for Medicaid, BCBS continued to pay for any services (mainly PT & OT) that they routinely did and for any left over balance that Medicare did not pay for the period of time she was Medicaid Pending. But once she was on Medicaid, BCBS got suspended (not cancelled but suspended) as Medicaid now went into the position of the secondary or supplemental policy to Medicare. Most insurers are going to do this.

If you go into a NH and apply for Medicaid (or if you are lucky enough to be in a state that does an AL diversion), you are required to do a co-pay or an "SOC" (share of cost in Medicaid speak) of your monthly income. Like for my mom, she gets $ 800 in SS and then 1K in federal, so every month has an income of $ 1,800.
(Now her Medicare is taken out of her SS still so it's really 900). Under her SOC she is required to pay the NH $ 1,740.00 a mo and she gets to keep $ 60 for her personal needs allowance. That's it, she has $ 60 a mo, really just enough for hair salon or a phone or cable @ the NH. There will be no funds to pay for other things. If you still have a home you can keep it under Medicaid rules but someone else will have to pay for everything on the property. If other debt like credit cards then either you let those go to collections or someone in the family steps in to pay on those. Medicaid requires the SOC to be paid first. Good luck.
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If you qualify for Medicaid you do not lose Medicare. Medicaid is like the guy in the circus parade who follows the elephants. He and Medicaid pick up what's left after the big guys go by. You.may not want to continue paying for the supplemental insurance if you qualify for Medicaid. Find out if you drop it, can you ever get it back when you might want to later. Contact your state for advice, SHIP program. If your question is does Medicaid take your income if it is paying for your care in Assisted Living or a nursing home, the general answer is yes. You get to keep some small amount of spending money each month, but your pension/Social Security are the elephants. After those guys go by, Medicaid is there with the man with the shovel to pick up the rest.
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