Medicare Coordinated Care

For people who have dual-eligibility, Medicare coordinated care plans consolidate their Medicare and Medicaid benefits through a single entity.

medicare and medicaid coordination

Who Is Eligible for Coordinated Care plans?

If an individual is 21 years of age or older, and eligible for both Medicare and Medicaid, they are considered dual-eligible. Additionally, if they experience significant health or financial risks and require more attention and support to help them reach their health goals they would qualify for dual coverage.

What is a Medicare Medicaid Coordinated Plan?

The Medicare Medicaid Coordinated Plan is a program created to manage Medicare benefits as well as most Medicaid benefits, in addition to some supplemental services.

Medicare is the primary payer for people with dual eligibility. Medicaid coverage picks up the costs that Medicare may not cover, such as deductibles and coinsurance. Medicaid might also cover long-term nursing home expenses, personal in-home care, and other supportive services not covered by Medicare.

Why Coordinated Care?

Coordinated care combines the coverage of Medicare and Medicaid benefits through a single source, which means a person’s healthcare decisions are based on their specific needs.


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