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Types of Medicaid and Health Insurance Assistance Programs

Read our Medicaid review to learn about the various types of Medicaid and the different programs available to Medicaid beneficiaries.

Many people may know Medicaid as a publicly-funded health insurance program for people with limited income or financial resources. But many people may not realize that there are actually several different types of Medicaid programs. 

Medicaid eligibility and coverage can vary by state. If you meet your state’s Medicaid eligibility requirements, you may qualify to receive assistance through one of the following types of Medicaid programs. 

  • Aged, blind and disabled (ABD) Medicaid: Available to those age 65 and over who are blind or otherwise disabled

  • Home and community-based service (HCBS): Coverage to help you age in place at home or in a community-based setting such as an assisted living facility

  • Institutional Medicaid, also called Long Term Care (LTC) Medicaid: Coverage available to residents of nursing homes

Medicaid is primarily designed to help individuals, families, children, the elderly, disabled persons and pregnant women who have limited financial resources or low incomes.

Additional types of Medicaid programs

Each state governs its own Medicaid program and is responsible for establishing its own set of benefits, costs and eligibility rules (while adhering to federal guidelines). That means the types of available Medicaid programs will differ from one state to the next.

But some of the types of Medicaid programs that you might find in certain states may include coverage for:

  • Individuals under the age of 21 who are on the autism spectrum
  • Foster care, adoption assistance and benefits for juvenile justice members
  • Those in need of long-term care
  • Those transitioning from long-term care back to the community
  • Those in need of transportation to medical appointments
  • Uninsured and underinsured pregnant women
  • Women with breast or cervical cancer

Types of Medicaid for Medicare beneficiaries

Certain individuals are eligible for both Medicare and Medicaid. This is known as “dual eligibility.” There are four different types of Medicare Savings Programs available to Medicare beneficiaries who meet certain eligibility requirements. 

In some states, you may qualify for one of the following Medicare Savings Programs even if you don’t qualify for Medicaid in your state.

Qualified Medicare Beneficiary (QMB) Program

This QMB program helps pay for Medicare Part A and Part B premiums, deductibles, coinsurance and copayments.

Specified Low-Income Medicare Beneficiary (SLMB) Program

This program helps pay for Medicare Part B premiums. 

Qualifying Individual (QI) Program

This program also helps pay for Medicare Part B premiums. You can’t get QI benefits if you qualify for Medicaid in your state.

Qualified Disabled Working Individual (QDWI) Program

This program helps pay Medicare Part A premiums for disabled persons who are working and meeting certain income limits. 

Dual-eligible Medicare Special Needs Plans (D-SNPs)

Dual-eligible beneficiaries may also join a certain type of Medicare Advantage plan called a Dual-eligible Special Needs Plan (D-SNP)

Medicare Advantage plans are sold by private insurance companies and offer all of the same benefits as Medicare Part A and Part B. In addition, many Medicare Advantage plans may cover some services and benefits not covered by Part A or Part B such as dental, vision or hearing coverage. 

Medicare Special Needs Plans are customized to the specific health care needs of individuals with particular medical conditions or living circumstances. A Dual-eligible Special Needs Plan has benefits tailored to the needs of someone with low income and resources.

All Medicare D-SNPs provide prescription drug coverage.

Contact your state Medicaid program

Contact your state Medicaid program to learn about the different types and benefits that may be available to you and for help determining your eligibility, costs and more.

If you’re interested in learning more about Medicare Special Needs Plans for people who are dual-eligible for Medicare and Medicaid, you can compare plans online to find out if any Medicare D-SNPs are available where you live.

You can also call to speak with a licensed insurance agent to learn more about Medicare Advantage plans and Medicare prescription drug coverage available in your area.

Find Medicare-Medicaid plans in your area.

Speak with a licensed insurance agent

1-800-557-6059

 

Christian

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.

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