Can one switch from Medicare Part B to Medicaid easily?

A fellow caregiver asked...

Is it possible for a NYC employee, diagnosed with dementia, severe hearing loss, glaucoma and crippling arthritis (must use a cane) to switch from Medicare Part B to Medicaid without affecting her small pension payments?

Expert Answer

If someone qualifies for Medicaid coverage, she gets that coverage in addition to Medicare Part B (not instead of Medicare Part B). If she qualifies for Medicaid, she would keep her Medicare Part B coverage and Medicaid would pay the Medicare Part B premium, deductible, and copayments. New York's Medicaid program also offers some coverage that's broader than what's provided by Medicare Part B. To find out what the extra coverage is, you can look at the Web site of the New York state Medicaid program.

When Medicaid decides on someone's eligibility, it looks at all their sources of income and assets. That includes pension payments, as well as Social Security and other sources of government benefits. If the total income and assets are below the limits set by the state's Medicaid program, then the person qualifies. Also, even if the person's income is above the state Medicaid limit, she may qualify anyway -- in a category called "medically needy" -- if paying her own regular medical bills would drop her income below the state's limit. Medicaid would not directly touch any of her pension income, but if her total income is above the Medicaid eligibility limit, Medicaid might require her to spend some of that pension income on her medical bills before she would be declared Medicaid eligible.