Medicare · Dual Coverage · Extra Help

Medicare & Medicaid (Dual Eligibility)

Millions of people qualify for both Medicare and Medicaid and don't fully use the help available. Dual-eligible plans and cost-assistance programs can cover premiums, copays, and more. Here's what to look for.

What "dual eligible" means

Dual eligible means you qualify for both Medicare (federal) and Medicaid (state). That can happen if you're 65+ with limited income, or under 65 with a qualifying disability and low income. About 12 million Americans are dual eligible — and they often receive significantly more benefits than people on Medicare alone, including help paying premiums, deductibles, and copays.

Dual Special Needs Plans (D-SNPs)

A D-SNP is a Medicare Advantage plan designed specifically for people who have both Medicare and Medicaid. It coordinates benefits from both programs and typically includes:

  • $0 plan premium (in addition to any Part B premium)
  • $0 copays for many services
  • Prescription drug coverage with low or no copays
  • Dental, vision, and hearing benefits
  • Transportation to medical appointments
  • A quarterly over-the-counter (OTC) allowance for health products
  • Meals after a hospital stay

You may be leaving benefits on the table

Programs like the Medicare Savings Programs and Extra Help (the Low-Income Subsidy) can pay your Part B premium and slash prescription costs — but they require an application many people never complete. Many dual-eligible individuals automatically qualify for Extra Help. If money is tight, it's worth checking.

Who qualifies — and how to apply in Florida

Medicaid eligibility is set by your state. In Florida, you generally qualify with limited income (roughly under $1,600/month for an individual) and limited resources (typically under about $9,430 for an individual), and you apply through the Department of Children and Families (DCF) at myflfamilies.com or 1-866-762-2237. We help confirm whether you may qualify, compare the D-SNPs in your area, and point you to the right enrollment resources — at no cost.

FAQ

Common questions

Can I have both Medicare and Medicaid at the same time?

Yes — about 12 million Americans are dual eligible. If you qualify, the two programs work together to give you additional benefits and lower costs.

What's the difference between a D-SNP and regular Medicare Advantage?

D-SNPs are Advantage plans built specifically for dual-eligible members. They coordinate Medicare and Medicaid, add perks like transportation, OTC allowances, and meals, and typically have $0 premiums and very low or no copays.

Do I lose Medicare if I get Medicaid?

No. They're separate programs. Medicaid doesn't replace Medicare — it supplements it, helping cover costs Medicare doesn't, like copays and premiums.

How do I know if I qualify for Extra Help?

Eligibility is based on income and resources, and the thresholds change annually. A quick review with us can tell you whether it's worth applying — and we'll help with the process if it is.

Are you connected to Medicare or the government?

No. Mere Benefits is a private, independent agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We don't offer every plan available in your area — to review all your options, contact Medicare.gov or 1-800-MEDICARE.

How much does it cost to work with Mere Benefits?

Nothing extra. Plan prices are set by the carriers and are identical whether you enroll on your own or with a licensed agent — we're paid by the carriers, so our guidance is free to you.

How do I get started?

Call or text (904) 654-5450, email info@merebenefits.com, or use our contact form. We'll set up a relaxed, no-pressure conversation — in person on the First Coast, or by phone and video.

Are you independent, or tied to one insurance company?

Independent. We aren't captive to a single insurer, so we compare the options across the carriers we represent and recommend what fits you — not what pays us most.

Will I have to change doctors?

Not if we can help it. Before recommending a plan we confirm your doctors are in-network and your prescriptions are covered, so keeping your care is part of the decision.

Can you help by phone and video, or only in person?

Both. We meet clients in person across Northeast Florida and Camden County, GA, and serve all 11 of our licensed states by phone and video.

Talk with a real person

Not sure where to start?

One free, no-pressure conversation and we'll translate your options into a clear recommendation — built around your doctors, medications, and budget.

  • No cost to you
  • RSSA® · CMIP®
  • No pressure, ever

Accessibility

Text size