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How To Sign Up For Medicare Advantage With Medicaid

By Zawn Villines
You can enroll in Medicare Advantage if you have Medicaid and are Medicare-eligible. Make sure you choose the right plan.

If you're currently a Medicaid recipient, you may not be aware that you could also qualify for Medicare Advantage. Medicare Advantage is a form of Medicare that allows beneficiaries to access private insurance polices. If you're eligible for Medicare Parts A and B, you are eligible for Medicare Advantage programs in your area. Dual eligibility means that you are eligible for both Medicare and Medicaid—usually because you have a low income and are Medicare-eligible.

Here's how to sign up for Medicare Advantage with Medicaid.

Determine Eligibility

Generally speaking, you are eligible for Medicare if you're age 65 or older. People under age 65 who have certain disabilities, as well as those who have End Stage Renal Disease, are also eligible. You can use The Offical U.S. Government Site for Medicare online in order to determine your eligibility. 

Enroll During Open Enrollment

You must enroll in Medicare Advantage during open enrollment, which is October 15 through December 7. During this period, you can choose your first Medicare or Medicare Advantage program, or switch from original Medicare to Medicare Advantage. You can also switch from Medicare Advantage back to original Medicare.

Medicare Advantage open enrollment, which extends from January 1 through March 31, allows you to switch from one Medicare Advantage plan to another. You can also drop a Medicare Advantage plan and return to original Medicare during this time period.

Find the Right Plan

While about a third of people eligible for Medicare choose a Medicare Advantage plan, Medicare Advantage is not right for everyone. It's important to carefully review plan documents. Make sure that you understand each of the different types of Medicare Advantage plans, which are:

  • Health Maintenance Organization (HMO) plans
  • Preferred Provider Organization (PPO) plans
  • Private Fee-for-Service (PFFS) plans
  • Special Needs Plans (SNPs)

The region in which you reside has a strong influence on the availability of specific Medicare Advantage policies. You can use The Official U.S. Government Site for Medicare to determine which programs are available to you, and to learn more about plan options to see which plan might best suit your needs. 

Be sure you can answer the following questions about your prospective plans:

  • What is the out-of-pocket maximum?
  • How much do premiums cost?
  • Are prescription drugs covered?
  • What specific services does the plan cover?
  • Does my doctor accept the plan?
  • Is this a 5-star plan?
  • Are there online reviews that provide additional information about the plan?
  • Do I know anyone who has this plan? Do they like it?
  • Which plan structure is right for me?

It might also be helpful to tally up the yearly medical expenses that exist with your current plan and compare them against projections for your prospective Medicare Advantage plan—based on all of the above questions and the specifics of the plan's coverage.