Can Medicare and Medicaid Dual Eligibility Ever be Seamless?

The efforts of Congress to coordinate Medicaid and Medicare into a smooth flowing process for those who qualify for both in theory was a great idea. The transition, though, is not always a seamless effort. As part of the Affordable Care Act, the Medicare-Medicaid Coordination Office was established to eliminate the transition problems that are sometimes present.

As estate planning lawyers, we know the process for qualifying for Medicaid alone is overwhelming. There are the many guidelines and rules that seem unnecessary or confusing. 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 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.

A Better Medicare and Medicaid Dual Eligibility Process

The Medicare-Medicaid Coordination Office serves people who are enrolled in both Medicare and Medicaid, known as dual eligibles. It also works to help identify those who do qualify, but may be unaware. 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.

This office 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”.

Affordable Care Act

As mentioned, this new office is part of the new healthcare laws. There are definitive goals outlined in the law and include:

• 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.

Benefits of Coordinated Effort

As you can see, this is a tall order for those establishing this new office; however, once it’s operating smoothly, we know that the ones who benefit from it are our clients and their families. This kind of overhaul is long overdue, but it’s a great start with great promise.

If there’s anything we can do to help you or a loved one with the qualifying process for Medicaid, Medicare or other government benefits, our team at Unsworth Law stands ready. Give us a call today and schedule an appointment.

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Ellen LaPlante

Ellen LaPlante is an attorney whose mission is to provide clients with guidance in Estate Planning, Elder Law, and Medicaid Preparation. She is barred in Vermont and New York. Ellen helps clients put together unique estate plans, including assistance with Trusts, Wills, Powers of Attorney, and Advance Directives. She also works with clients on Medicaid Planning and qualifying for Medicaid assistance.

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