Medicare and Medicaid are programs offered to United States citizens to help cover medical costs. Here, find information about each. This information explain the distinctions and also what you can do if your loved one doesn’t have Medicare or Medicaid.
Medicare is the federal health insurance program for people who are 65 or older. It is also for certain people with disabilities, and people with end-stage renal disease. This is permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.
The different parts of this program help cover specific services:
- Medicare Part A (Hospital Insurance). Part A covers inpatient hospital stays, skilled nursing facility care, and hospice care. It also covers some home health care.
- Medicare Part B (Medical Insurance). Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
- Medicare Part C (Medicare Advantage Plans). This gets offered by a private company that contracts with this plan. It provides you with all your part A and part B benefits. Medicare advantage plans include health maintenance organizations, preferred provider organizations and private fee-for-service plans. It also includes special needs plans and Medicare medical savings account plans. If you’re enrolled in a Medicare advantage plan, most Medicare services are covered. They aren’t paid for under original Medicare. Most Medicare advantage plans offer prescription drug coverage.
- Medicare Part D (prescription drug coverage). Part D adds prescription drug coverage to original Medicare. This coverage happen for some Medicare cost plans and some Medicare private-fee-for-service plans. It also includes the Medicare medical savings account plans. Insurance companies offer these plans and other private companies approved by Medicare. Medicare advantage plans may also offer prescription drug coverage. This coverage follows the same rules as Medicare prescription drug plans.
This program is a great program for elderly citizens in our country. Each part helps to cover a different problem. This program can provide peace of mind so you don’t have to worry about emergency situations.
Medicaid is a joint federal and state program. It helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare. For example, it covers nursing home care and personal care services.
- How to apply for Medicaid:
Each state has different rules about eligibility and applying for Medicaid. Call your state Medicaid program to see if you qualify and learn how to apply. The phone numbers to call the Connecticut Medicaid office is 800-842-1508. Or you can make an in state call to 860-424-4908.
- Medicaid spend down:
Even if your income exceeds Medicaid income levels in your state, you may be eligible. You might be eligible under Medicaid spend down rules. Under this rule, you are eligible in some states as “medically needy”. You are eligible even if you have too much income to qualify. This process allows you to subtract your medical expenses from your income. This allows you to be eligible for Medicaid.
To be considered medically needy, your measurable resources must be under the resource amount. Call your state Medicaid program to see if you qualify and learn how to apply.
Some people who are eligible for both Medicare and Medicaid are called “dual eligible.” If you have Medicare and full Medicaid coverage, most of your health care costs get covered.
You can get your Medicare coverage through original Medicare. Or it can get covered through a Medicare advantage plan (part C). If you have these services, you’ll get part D prescription drugs through Medicare. You’ll automatically qualify for extra help paying for drug coverage. You qualify for help with Medicare prescription drug coverage (part D). Medicaid may still cover some drugs and other care that Medicare doesn’t cover.
If your loved one doesn’t have Medicare or Medicaid, there are things you can do. You can always get private medical insurance to help cover the costs of your loved one’s needs. You can get any kind of program or package that fits your loved ones needs best. Every citizen might not qualify for Medicare or Medicaid. You might need to get an outside health insurance policy. This will cost you more than Medicare or Medicaid will. But, it will help you cover at least some of the costs of the care your loved one needs.
Medicare and Medicaid can be helpful to you and your family when covering costs of your loved one’s care. It can get expensive and when you qualify for the program, it will help you out. If you don’t qualify, you can always get a private insurance policy to help cover the costs. It might be more expensive, but nowhere near the cost you would have to pay if you didn’t have any coverage at all.