Dual Eligible Recipients and Better Health Care
Ohio is one of just ten states that has been federally approved for combining Medicare and Medicaid in an effort of providing better coordination, better health care and lower pricing for enrollees. While there are many adjustments that will have to be worked out, it’s believed that combining the two programs – Medicare for those over the age of 65 or who are disabled and Medicaid for those who have low incomes – will result in big improvements on every level. There are approximately 182,000 Ohioans who have both Medicare and Medicaid coverage, known as dual eligible.
Currently, there are approximately 106 million Americans who are enrolled in either Medicaid or Medicare. Of those, 51 million are eligible for dual coverage or are already receiving benefits from both programs. The programs are designed to not overlap the other, but until recently, many believed combining the two would serve little purpose.
Congress put into place a new federal designation, the Center for Medicare and Medicaid Innovation (CMMI), in an effort of easing the implementation process. You may recall Governor Kasich authorized Ohio Medicaid to work through CMMI and then put into place its version of a Medicare Medicaid Integrated Care Delivery System, or ICDS. This streamlined effort is an added benefit for those on either or both programs and should provide for a more seamless experience for recipients.
So what does this mean for those considered dual eligible in Ohio? The Ohio Department of Medicaid has titled the program MyCare Ohio and offers at no cost to those who are on Medicaid and Medicare services and benefits such as an around the clock “nurse advice” number that can provide immediate assistance for those who have questions or concerns of a medical nature and a single, seamless health plan with one point of contact, which will save both time and frustration. If you’ve ever spoken to more than one representative with any company or agency, you understand the frustration of having to re-explain your situation each time you call. MyCare Ohio eliminates that.
There are also benefits and considerations for those who reside in nursing homes, assisted living facilities or who receive mental health care.
It’s believed this combination effort will result in big savings for Ohio taxpayers. Already, $3 billion has been saved over the past two years and it’s the successful streamlining efforts that have led to those savings.
Remember, there are still important legalities Medicaid and Medicare recipients must comply with, including asset protection and out of pocket expenses. While MyCare Ohio is a great first step, don’t underestimate the importance of living trusts, healthcare directives and financial powers of attorney. These elements come together to define a strong estate plan that protects you in the here and now and protects your loved ones later. The complex legal considerations are important and the worst thing anyone can do is delay these important decisions.
We invite you to contact our office today to learn more about Medicaid, Medicare and how MyCare Ohio brings enrollees the best of both programs. We’re happy to answer questions and discuss options that will best suit your needs.