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Home » Elder Law » Medicaid Planning » Understanding Medicare and Medicaid Dual Eligibility

Understanding Medicare and Medicaid Dual Eligibility

January 19, 2016Medicaid Planning

As part of the Affordable Care Act, the Medicare-Medicaid Coordination Office was established to eliminate the transition problems that are sometimes present when clients seek Medicare and Medicaid dual eligibility.

As estate planning lawyers, we know the process for qualifying for Medicaid alone is overwhelming. There are the many guidelines and rules that can be confusing. From the spend down rules to the 5 year lookback period, our job is to guide our clients through the process so that they have a far better chance of being approved and with fewer setbacks during that

Wikipedia
Wikipedia

process. The Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office) is a natural progression for those with Medicaid and Medicare – and one that’s long overdue.

This latest division is designed to serve those who are already dual eligible or are seeking dual eligibility. It also works to help identify those who do qualify, but may be unaware of their options. Its mission is to ensure those who qualify for both programs have access to the benefits of each while also working towards a more cost effective approach. It works with both programs across all of the applicable federal and state agencies. They want to “develop new care models and improve the way Medicare-Medicaid enrollees receive health care”.

From what we’ve been able to gather, it appears to be a solid transitional office that’s keeping up with the expected growing pains.

To be sure, there are specific goals that define the new division. While much of this will go into full effect in 2016, there are positive signs to point to a preparedness that’s often lacking in federal agencies. According to the law, the coordination office’s purpose is:

  • To provide dual eligible individuals full access to all benefits enrollees are entitled to under the programs.
  • To simplify the processes for dual eligible individuals so that access to the services isn’t overwhelming or complicated.
  • To improve the quality of health care and long-term services for those who are dual eligible.
  • To educate those who are dual eligible so that they know the many coverage opportunities.
  • To eliminate the proverbial “red tape” that often comes with Medicaid and Medicare.
  • To improve care for dual eligible and eliminate any potential road blocks that would prevent those who are qualified from seeking assistance.
  • Finally, to eliminate what the office says are “cost shifting” problems between the two programs, which often mean delays for enrollees.

For our clients, we know the importance of dual eligibility. Time will tell the tale, but for now, we stand ready to provide our clients with solid guidance in qualifying for Medicare, Medicaid or both and to provide for all of their estate planning needs.

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Daniel DeBruyckere
Daniel DeBruyckere
Attorney Daniel A. DeBruyckere has been practicing law in New Hampshire and Massachusetts since 1998, and has helped hundreds of clients with their estate planning and elder care issues. He is very well respected in the area of estate planning, probate, trust administration, elder law issues, and business planning.
Daniel DeBruyckere
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