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  • Medicare and Medicaid Dual Eligibility in South Dakota 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in South Dakota: Key Facts

    Dual Eligible Population Approximately 8% of South Dakota Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    South Dakota Medicaid Agency South Dakota Department of Social Services
    Phone 605-773-3165

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In South Dakota, approximately 8% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in South Dakota

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in South Dakota that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in South Dakota

    Full dual eligible beneficiaries in South Dakota receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by South Dakota Medicaid program)

    How to Apply for Dual Eligibility in South Dakota

    To apply for Medicaid in South Dakota and potentially qualify for dual eligibility, contact the South Dakota Department of Social Services at 605-773-3165. You can also apply online through South Dakota’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in South Dakota

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In South Dakota, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in South Carolina 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in South Carolina: Key Facts

    Dual Eligible Population Approximately 14% of South Carolina Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    South Carolina Medicaid Agency South Carolina Department of Health and Human Services
    Phone 803-898-2500

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In South Carolina, approximately 14% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in South Carolina

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in South Carolina that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in South Carolina

    Full dual eligible beneficiaries in South Carolina receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by South Carolina Medicaid program)

    How to Apply for Dual Eligibility in South Carolina

    To apply for Medicaid in South Carolina and potentially qualify for dual eligibility, contact the South Carolina Department of Health and Human Services at 803-898-2500. You can also apply online through South Carolina’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in South Carolina

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In South Carolina, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in Rhode Island 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in Rhode Island: Key Facts

    Dual Eligible Population Approximately 9% of Rhode Island Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    Rhode Island Medicaid Agency Rhode Island Executive Office of Health and Human Services
    Phone 401-462-5300

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Rhode Island, approximately 9% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in Rhode Island

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Rhode Island that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in Rhode Island

    Full dual eligible beneficiaries in Rhode Island receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by Rhode Island Medicaid program)

    How to Apply for Dual Eligibility in Rhode Island

    To apply for Medicaid in Rhode Island and potentially qualify for dual eligibility, contact the Rhode Island Executive Office of Health and Human Services at 401-462-5300. You can also apply online through Rhode Island’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in Rhode Island

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Rhode Island, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in Pennsylvania 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in Pennsylvania: Key Facts

    Dual Eligible Population Approximately 16% of Pennsylvania Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    Pennsylvania Medicaid Agency Pennsylvania Department of Human Services
    Phone 717-787-1870

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Pennsylvania, approximately 16% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in Pennsylvania

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Pennsylvania that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in Pennsylvania

    Full dual eligible beneficiaries in Pennsylvania receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by Pennsylvania Medicaid program)

    How to Apply for Dual Eligibility in Pennsylvania

    To apply for Medicaid in Pennsylvania and potentially qualify for dual eligibility, contact the Pennsylvania Department of Human Services at 717-787-1870. You can also apply online through Pennsylvania’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in Pennsylvania

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Pennsylvania, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in Oregon 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in Oregon: Key Facts

    Dual Eligible Population Approximately 10% of Oregon Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    Oregon Medicaid Agency Oregon Health Authority
    Phone 503-945-5772

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Oregon, approximately 10% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in Oregon

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Oregon that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in Oregon

    Full dual eligible beneficiaries in Oregon receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by Oregon Medicaid program)

    How to Apply for Dual Eligibility in Oregon

    To apply for Medicaid in Oregon and potentially qualify for dual eligibility, contact the Oregon Health Authority at 503-945-5772. You can also apply online through Oregon’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in Oregon

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Oregon, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in Oklahoma 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in Oklahoma: Key Facts

    Dual Eligible Population Approximately 13% of Oklahoma Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    Oklahoma Medicaid Agency Oklahoma Health Care Authority
    Phone 405-522-7300

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Oklahoma, approximately 13% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in Oklahoma

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Oklahoma that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in Oklahoma

    Full dual eligible beneficiaries in Oklahoma receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by Oklahoma Medicaid program)

    How to Apply for Dual Eligibility in Oklahoma

    To apply for Medicaid in Oklahoma and potentially qualify for dual eligibility, contact the Oklahoma Health Care Authority at 405-522-7300. You can also apply online through Oklahoma’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in Oklahoma

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Oklahoma, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in Ohio 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in Ohio: Key Facts

    Dual Eligible Population Approximately 15% of Ohio Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    Ohio Medicaid Agency Ohio Department of Medicaid
    Phone 614-466-6282

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Ohio, approximately 15% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in Ohio

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Ohio that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in Ohio

    Full dual eligible beneficiaries in Ohio receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by Ohio Medicaid program)

    How to Apply for Dual Eligibility in Ohio

    To apply for Medicaid in Ohio and potentially qualify for dual eligibility, contact the Ohio Department of Medicaid at 614-466-6282. You can also apply online through Ohio’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in Ohio

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Ohio, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in North Dakota 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in North Dakota: Key Facts

    Dual Eligible Population Approximately 7% of North Dakota Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    North Dakota Medicaid Agency North Dakota Department of Human Services
    Phone 701-328-2321

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In North Dakota, approximately 7% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in North Dakota

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in North Dakota that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in North Dakota

    Full dual eligible beneficiaries in North Dakota receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by North Dakota Medicaid program)

    How to Apply for Dual Eligibility in North Dakota

    To apply for Medicaid in North Dakota and potentially qualify for dual eligibility, contact the North Dakota Department of Human Services at 701-328-2321. You can also apply online through North Dakota’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in North Dakota

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In North Dakota, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in North Carolina 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in North Carolina: Key Facts

    Dual Eligible Population Approximately 15% of North Carolina Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    North Carolina Medicaid Agency North Carolina Department of Health and Human Services
    Phone 919-855-4100

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In North Carolina, approximately 15% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in North Carolina

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in North Carolina that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in North Carolina

    Full dual eligible beneficiaries in North Carolina receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by North Carolina Medicaid program)

    How to Apply for Dual Eligibility in North Carolina

    To apply for Medicaid in North Carolina and potentially qualify for dual eligibility, contact the North Carolina Department of Health and Human Services at 919-855-4100. You can also apply online through North Carolina’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in North Carolina

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In North Carolina, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

  • Medicare and Medicaid Dual Eligibility in New York 2026: Income Limits, Benefits & How to Apply

    Dual Eligibility in New York: Key Facts

    Dual Eligible Population Approximately 17% of New York Medicare beneficiaries
    QMB Income Limit (Individual) $1,255/month (100% FPL)
    SLMB Income Limit (Individual) $1,694/month (120% FPL)
    New York Medicaid Agency New York State Department of Health
    Phone 518-474-7354

    What Is Dual Eligibility?

    Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In New York, approximately 17% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

    Medicare Savings Programs in New York

    Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in New York that helps pay your Medicare costs. There are four MSP levels:

    Program Individual Income Limit What It Pays
    Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
    Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
    Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
    Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

    Benefits of Full Dual Eligibility in New York

    Full dual eligible beneficiaries in New York receive:

    • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
    • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
    • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
    • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
    • Additional services — Dental, vision, hearing, and transportation (varies by New York Medicaid program)

    How to Apply for Dual Eligibility in New York

    To apply for Medicaid in New York and potentially qualify for dual eligibility, contact the New York State Department of Health at 518-474-7354. You can also apply online through New York’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

    D-SNPs: Dual Eligible Special Needs Plans in New York

    Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In New York, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.