Dual Eligibles
Enrolling Medicare Recipients Into Medical Assistance Programs
Persons who have Medicare may also be eligible for some degree of Medical Assistance. Because Medicare has co-payments, premiums, and deductibles and because it does not provide comprehensive coverage of all needed healthcare services, lower-income persons on Medicare should be encouraged to explore whether they also are eligible to take advantage of Medical Assistance coverage. Over 200,000 persons on Medicare in Pennsylvania are eligible for but not enrolled in some degree of Medical Assistance coverage.
The Pennsylvania Health Law Project is the lead agency of a coalition of organizations working to improve enrollment of eligible Medicare beneficiaries in Medical Assistance Programs. The coalition, the Pennsylvania Campaign for Affordable Health Care, is a grant recipient of the Robert Wood Johnson Foundation for its work on improving enrollment in Pennsylvania. For more information about this coalition and its work, see the Pennsylvania Campaign for Affordable Health Care website.
Eligibility For Medical Assistance Programs
Persons with Medicare may be eligible for:
• Full Medical Assistance coverage through:
• The Healthy Horizons Program (as a QMB+)
• The Medical Assistance For Workers With Disabilities Program or
• One of the Home and Community Based Services Waiver Programs
• Having some or all of their Medicare premiums, deductibles, and co-payments paid through:
• The Medicare Savings Programs (as a QMB, SLMB, or QI-1)
To find out if a person on Medicare might be eligible, call the Pennsylvania Health Law Project at (800)274-3258 or go to our online Quickscreen Tool.
Accessing Health Care Services When You Have
Medicare and Medical Assistance
Accessing health care services when you have both Medicare
and Medical Assistance can be complicated. We have developed
several information brochures on this topic:
For information or assistance in accessing health care services
when you have Medicare and Medical Assistance, call the Pennsylvania
Health Law Project at 800-274-3258.
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