Health Insurance Does Not Preclude Access to Medicaid Benefits

December 21st, 2011

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We’ve been asked several times whether or not a Medicaid applicant can have a primary (and in many instances secondary) health insurance plan, and, if so, if he or she must give up such plans once accepted to the Medicaid program.  People often believe that their medical insurance coverage precludes them from becoming Medicaid eligible, and are worried that they may lose their current benefits by becoming a Medicaid recipient.

Having medical insurance, either through Medicare or any other private plan (such as GHI or Blue Cross Blue Shield), does not prevent an individual from becoming Medicaid eligible.  Additionally, if an individual is accepted to the Medicaid program, he or she will not be forced to give up any existing health insurance plans.

Since medical insurance does not pay for the catastrophic cost of long term care, it is often necessary for an individual to access Medicaid for assistance with paying for home care or nursing home care, even if he or she has ample health insurance.

When it comes to medical coverage, Medicaid is the “payor of last resort,” so a patient’s primary and secondary insurance policies will be accessed before Medicaid contributes.  In fact, Medicaid advises that a Medicaid recipient maintain all insurance policies he or she currently has, and even offers incentives such as deducting the cost of the premiums from the recipient’s monthly income calculation or paying the premiums under certain situations.  Also, it is advisable that current health insurance be maintained so that the Medicaid recipient can continue to see his or her doctors and specialists, even if they don’t accept Medicaid.

The fact that you have Medicare or a supplemental health insurance plan should not keep you from accessing Medicaid benefits if you need assistance with paying for long-term care.  Elder law attorneys can advise you on how to get the most benefits available to you, without giving up any insurance you already have.

Entry Filed under: Health Insurance Coverage,Medicaid Planning,Medicare Coverage