A person who qualifies for both Medicaid and Medicare coverage is considered a "dual eligible." Many individuals with intellectual and developmental disabilities (IDD) qualify for Medicaid first, and later may also qualify for Medicare.
The State Health Insurance Assistance Program (SHIP) provides free help to NJ Medicare beneficiaries who have problems with, or questions about their health insurance.
NJ SHIP published the 2026 Medicare Part D Stand-Alone Prescription Drug Plans. Enrollment in a Medicare Part D drug plan is mandatory for dual eligibles, unless the individual has creditable drug coverage from a private health insurance plan as good or better than Medicare Part D.
Recent Webinars
12/4/25 “Dual Eligibility” - Medicaid and Medicare Enrollment for Adults with IDD
11/6/25 Dual Eligibility - Understanding Medicare + Medicaid Enrollment & Coordination of Benefits
11/7/24 Update for 2025 on the Medicare Drug Benefit for People Who Have Both Medicare and Medicaid (the Dual Eligibles)
FAQs for Dual Eligibles
The Arc of New Jersey Health Care Advocacy program has distributed information in the form of Frequently Asked Questions (FAQs) fact sheets, to respond to the questions that families have been asking:
The Centers for Medicare & Medicaid Services (CMS) created helpful fact sheets: