Turning 65 and Transitioning to Dual Medicare, Medicaid Coverage

If you or a loved one is approaching the age of 65, you need to begin familiarizing yourself with dual Medicaid/Medicare coverage and what sorts of costs it will cover. There is a seven-month initial enrollment period for you to sign up for Medicare; for most people, your seven-month enrollment period usually extends from the three months prior to the month of your 65th birthday and for three months following the month of your birthday.

Once you have both Medicaid and Medicare coverage, you have access to some benefits that you didn’t have beforehand. Medicare Part D covers prescription drugs, plus you will automatically qualify for extra help with your prescriptions. If you have a relatively low income and few assets, you may qualify for help paying certain costs related to Medicare, such as Medicare Part B premiums, deductibles, and coinsurance. Depending on your income, you also may be eligible for one or more of four other programs to help pay your Medicare premiums:

  • Qualified Medicare Beneficiary (QMB) Program
  • Specified Low-Income Medicare Beneficiary (SLMB) Program
  • Qualifying Individual (QI) Program
  • Qualified Disabled and Working Individuals (QDWI) Program

The Medicare Savings Program in your state may differ to some degree, but they do exist in every state. As a result, you should contact the Wisconsin state Medicaid program for more information about what these programs can do for you.

The transition to dual Medicare and Medicaid coverage is not always smooth, so it is best that you have the information that you need if you are in this situation. Part of that insurance coverage may assist you with the costs of long-term care, depending on the situation. With long-term care also comes an increased potential for abuse and neglect. If you or a loved one is seriously injured as a result of elder abuse, or your family has suffered the loss of a loved one due to negligence by nursing home or assisted living facility staff, you may be entitled to compensation.  At Boller & Vaughan, our Madison long-term care abuse and neglect lawyers can help you with these determinations, and support you through any legal claims that you may have.


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