Why choose Medicare advantage if you have Medicaid?

[pren.up]

Genuine question I've been thinking about....if someone is dual eligible and already has both Medicare and Medicaid, what's the incentive to enroll in a Medicare advantage plan? Doesn't Medicaid already cover the gaps that Medicare doesn't, including most prescriptions, co-pays, and even some extras like transportation?, yes, there are dual eligible special needs plans under Medicare Advantage that are designed for those with both, but I'm curious what the actual benefit is if Medicaid already foots the bill, is it about care coordination? extra perks like dental or vision, or are there situations where Medicaid doesn't cover something and advantage plans actually do better?

 

[Riry Jones]

Great question, I think it really comes down to care coordination and extras. Dual SNPs often bundle services better, offer extras like dental, vision, OTC cards, and simplify access. Medicaid covers gaps, but Advantage plans streamline it

 

[pudding_6]

@pren.up that's actually a very common question. Medicaid's coverage can vary from state to state and might not be as robust as a D-SNP's benefits.
Many of these plans offer enhanced supplemental benefits that go beyond what Medicaid provides, such as a generous dental allowance, comprehensive vision benefits, and a quarterly allowance for OTC products.
Plus, the D-SNP provides more consistent, national benefits that don't change based on state rules

 

[WackoJ]

That's a really interesting point, do you know if dual-eligible special needs plans under Medicare Advantage actually provide better care coordination or extra benefits that Medicaid alone doesn't cover?