Save on Medicare Costs: Extra Help, Medicare Savings Programs, and Dual Eligibility

Dual Eligibility Program (Medicare and Medicaid)

Dual eligibility means you qualify for both Medicare and Medicaid. While Medicare and Medicaid are different, they work together to provide more coverage.

Full Dual vs. Partial Dual Medicare Eligibility

Dual eligibility is categorized into two levels based on your income and the scope of benefits you qualify for through state Medicaid:

• Full Dual Eligibility: Individuals qualify for complete Medicaid coverage alongside their Medicare benefits. Medicaid acts as the secondary payer for medical services, covers Original Medicare cost-sharing (deductibles, copays, and coinsurance), and pays for comprehensive long-term care services that Medicare does not cover, such as nursing home care and in-home personal care assistance.

• Partial Dual Eligibility: Individuals earn slightly too much to qualify for full Medicaid benefits but meet the income criteria for a Medicare Savings Program (MSP). In this case, Medicaid assists by paying for Medicare Part B monthly premiums (and in some cases, Part A premiums and cost-sharing) through programs like Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), or Qualifying Individual (QI).

2027 Updates for Under-65 Disabled Beneficiaries

If you are under 65, receive Medicare due to a disability, and rely on Medicaid for dual-eligible status, major federal regulatory changes could jeopardize your benefits. By January 2027, 42 states must enforce new mandatory Medicaid work rules requiring expansion adults ages 19 to 64 to document at least 80 hours per month of work, job training, or community engagement.

Beneficiaries under age 65 who do not hold formal Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits are at high risk of procedural disenrollment unless they explicitly file for a certified "medically frail" exemption or maintain qualifying monthly hours.

Early State Rollouts Require Immediate Action: Three states are enforcing these strict compliance rules well ahead of the 2027 federal mandate:

• Nebraska: Enacting work reporting requirements as of May 1, 2026.

• Montana: Beginning enforcement on July 1, 2026.

• Iowa: Rolling out compliance checks on December 1, 2026.

If you live in these states or rely on Medicaid expansion coverage, make sure to verify your ongoing eligibility, confirm your exemption status, and submit required documentation promptly to protect your dual-eligible benefits.

Dual Eligible Special Needs Plans (D-SNP) Benefits

A D-SNP is a special type of Medicare Advantage plan for dual-eligible seniors. Many offer $0 dental, vision, and hearing care.

Important for 2026: To get extra benefits like healthy food or utility cards, insurance companies now require doctor-verified chronic conditions (like diabetes or heart disease). These plans also provide Care Coordination, which means a dedicated team helps manage all your doctors and appointments in one place.

While D-SNPs provide substantial benefits, upcoming federal mandates from the Centers for Medicare & Medicaid Services (CMS) are changing how these plans operate. Currently, some dual-eligible beneficiaries mix and match—holding a Medicare D-SNP with one private insurance company while receiving their Medicaid managed care coverage through a completely separate insurer. CMS is eliminating split-carrier coverage to streamline care administration. By 2027, if you choose a private Medicare D-SNP plan, you must use that exact same insurance carrier (or its affiliated Medicaid health plan) for your Medicaid coverage. 

You don’t have to navigate these policy changes alone. A SelectQuote licensed insurance agent can help you review your current carriers and coverage, explain what changes (if any) you can expect, and keep you informed about future regulatory updates. 

How to Apply for Medicare Savings Programs Online

Ready to start saving? Follow these three simple steps:

1. SSA.gov: Visit the Social Security website to apply for Extra Help (LIS) first.

2. State Portal: Apply for Medicaid or an MSP through your state’s social services or health department website.

3. Licensed Advisor: Call SelectQuote. Our licensed insurance agents can check if your specific plan supports these benefits and help you find the best coverage for your needs.