Medicare and Medicaid are sometimes hard to understand, especially if you are eligible for both insurance programs. This month’s article will discuss how the two programs work together and how to apply for both. Centers for Medicare & Medicaid Services (CMS) is the agency which provides regulatory oversight over both programs. Medicare is a federal health insurance program for people age 65 or older. People younger than age 65 with certain disabilities, permanent kidney failure, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), may also be eligible for Medicare. Medicaid in Alaska is a joint federal and state health insurance program known locally as DenaliCare; considered “the payer of last resort,” Medicaid is the primary Alaska-managed system financing basic health and long-term care services for vulnerable Alaskans.
Medicaid works with Medicare
If you are eligible for both Medicare and Medicaid, you may enroll in both. Some people may say you are “dually eligible.” Here are a few examples of how Medicaid works with Medicare:
Medicaid can provide secondary insurance. This means that Medicare would pay for your care first, and then Medicaid may cover any remaining costs like coinsurances and copays.
Medicaid can pay your premiums through the Medicare Savings Program (MSP). In most cases, if you have both Medicare and Medicaid, the State of Alaska will pay your Medicare monthly premiums.
Dually eligible people are automatically enrolled in Extra Help, offering lower prices for prescription drug costs.
Applying for Medicaid
Alaskans can now apply for multiple public assistance services including Medicaid directly from their phone through a new mobile-friendly Application for Services that makes it easier to apply for benefits online. The application allows new applicants to apply using a single streamlined form, replacing the previous online application; paper applications will continue to remain available for those who prefer that option. Available through the Alaska Connect Portal (https://alaskaconnect.ilinx.com/engage/dpa), questions are tailored to meet the applicant’s needs, reducing unnecessary paperwork and simplifying the process. Applicants can also upload supporting documents directly through the application, including pay stubs, identification, birth certificates and utility expense documentation. After applying, users may also choose to receive confirmation by text message or email that includes the date and time their application was received. Alaskans who do not have access to a mobile device or prefer in-person assistance can still apply by calling the Division of Public Assistance at (800) 478-7778 or visiting a local office.
Applying for Medicare
The gateway for all Medicare applications is through the Social Security Administration, which reviews enrollment eligibility. If you are already receiving Social Security retirement benefits, enrollment into Medicare is automatic once you turn age 65. If you begin receiving Social Security retirement benefits after age 65, then you need to apply by calling, going online, or visiting a local Social Security office; in Alaska, the three local offices are in Anchorage, Juneau and Fairbanks. If you are receiving Social Security disability benefits, then normally Medicare begins after two years (or 24 months of disability benefits).
Both Medicare and Medicaid have significant and nuanced policies. For any Medicare (or Medicaid) related questions, please feel free to contact the State of Alaska Medicare Information Office at (800) 478-6065 or (907) 269-3680; our office is also known as the State health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers (MIPPA) program. If you are part of an agency or organization that assists Seniors with medical resources, consider networking with the Medicare Information Office. Call us to inquire about our Ambassador program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor for the Alaska Medicare Information Office.
