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Can You Have Medicaid and Private Health Insurance?

Medicaid is a U.S. entitlement program that pays medical bills for eligible low-income families and qualifying aged, blind, and disabled individuals whose income can’t cover necessary medical services. Besides income, other factors may qualify you for Medicaid, depending on your qualifying category.

But you may be wondering if you can qualify for Medicaid and still apply for private health insurance. Well, if your income is low and you have minor children, both you and your children may be eligible for Medicaid, even if you already have private health insurance. But that’s just the tip of the iceberg, there’s more to juggling to achieve the best of both worlds with Medicaid and private insurance.

There are a few upsides to being eligible for both Medicaid and private insurance. For services covered by both programs, private insurance will pay first, then Medicaid picks up the difference between your provider’s allowable charge and private insurance payment, up to your state’s Medicaid payment limit.

Private health insurance policies usually have copay and deductible requirements. If you qualify for both Medicaid and private insurance, Medicaid may cover these out-of-pocket expenses for you.

You can use Medicaid as secondary insurance after your employer-sponsored plan. Your employer-sponsored plan pays your health provider first and Medicaid will pick up what your employer plan doesn’t cover.

If your service provider won’t take your Medicaid and private insurance card, your insurance company may help you locate a doctor in its provider network.

Need help figuring out your insurance options? Call Cosmo Insurance Agency today to speak with a broker.

Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.

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2024