| Medicaid | |
| Medicaid is a program that provides medical assistance to needy persons. It is not a program directed primarily to the elderly, but rather to the poor. It depends on financial need, low income and low assets. Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. | |
| Medicaid is not available to seniors under 65 unless they are blind or disabled. | |
| If someone over 65 lives with an adult child, the child's income and assets do not count in determining eligibility. Only the seniors income assets are counted. | |
| Remember, Medicaid helps needy people pay for medical care. In determining your eligibility for Medicaid they do not look at how much your rent, car payments or food costs. They only look at medical expenses. | |
| Medical expenses include: | |
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- Care from hospitals, doctors, clinics, nurses, dentists, podiatrists and chiropractors.
- Drugs, medical supplies and equipment.
- Health insurance premiums.
- Transportation to get medical care.
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| At the present time, there are TWO ways to receive Medicaid: | |
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- Supplemental Security Income eligibility may provide Medicaid.
- Medicaid Spend-down.
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| Spend-down is similar to a deductible or co-pay amount you must pay before you can receive Medicaid. You must meet the spend-down every month. Once you meet your spend-down you are eligible for Medicaid for the remainder of the month. | |
| To qualify for Medicaid a person must pass FOUR eligibility tests: | |
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- Categorical Eligibility - Aged 65, blind or disabled
- Non Financial Eligibility - State Resident, Citizen/Alien Status, Social Security Number
- Financial Eligibility Requirements - Income, Assets
- Procedural Requirements - Complete and sign an application form; Provide proof of eligibility; Report changes in circumstances
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| Medicare | |
| Medicare is a Health Insurance Program for: | |
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- People 65 years of age and older.
- Some people with disabilities, under 65 years of age.
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
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| Medicare Has Four Parts: | |
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- Part A (Hospital Insurance)
- Part B (Medical Insurance)
- Part C (Medicare Advantage Plans) This combines Part A & Part B and sometimes Part D (managed by private insurance companies)
- Part D (Prescription Drug Coverage)
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| You May Have Choices in How You Get Your Health Care... | |
| The Original Medicare Plan — This plan is available everywhere in the U.S. It is the way most people get their Medicare Part A and Part B benefits. You may go to any doctor, specialist, or hospital that accepts Medicare. Medicare pays its share and you pay your share. Some things are not covered, like prescription drugs. | |
| Medicare Managed Care Plans — These are health care choices (like HMOs) in some areas of the U.S. In most plans, you can only go to doctors, specialists, or hospitals that are part of the plan. Plans must cover all Medicare Part A and B benefits. Some plans cover extras, like prescription drugs. | |
| Private Fee-for-Service Plans — This is a new Medicare health care choice in some areas of the U.S. You may go to any doctor, specialist, or hospital. Plans must cover all Medicare Part A and B benefits. Some plans cover extras, like extra days in the hospital. The plan decides how much you pay. | |
| Medicare Premium Amounts for 2008 | |
| Part A - (Hospital Insurance) Premium | |
| Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare covered employment. | |
| $423.00 per month (Note: This premium is paid only by individuals who are not otherwise eligible for 2008 premium-free hospital insurance and have less than 30 quarters of Medicare covered employment). | |
| Most people get Part A automatically when they turn 65. | |
| Part B - (Medical Insurance) Premium | |
| $96.40 per month. | |
| Original Medicare Plan Deductible & Coinsurance Amounts for 2008 | |
| Part A: (Hospital Insurance) | |
| Deductible: | |
| $1024.00 (Per Benefit Period) | |
| Coinsurance: | |
| $256.00 a day for the 61st - 90th day each benefit period. | |
| $512.00 a day for the 91st - 150th day for each lifetime reserve day (total of 60 lifetime reserve days - non-renewable). | |
| Skilled Nursing Facility Coinsurance: | |
| $128.00 a day for the 21st - 100th day each benefit period. | |
| Part B: (Medical Insurance) | |
| Deductible: | |
| $135.00 per year. | |
| For more details about Medicare or for the new 'Medicare & You 2008' guide, call 800-633-4227 or visit www.medicare.gov.
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| The above information was obtained from www.medicare.gov.
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