Many people assume they don't qualify for help, and they never look into it. Don't make that mistake. If you have a low income and few assets, you may qualify for help.
Medicare Advantage and Medicare Supplements
The goal of Medicare Advantage and Medicare Supplements is to keep you healthy through the use of regular checkups and annual testing. The overall goal is to make things easier for you.
Medicare, established in 1965, provides health coverage to Americans who are 65 years and older, who have disabilities, or who have end-stage renal disease. This federal program is composed of four main parts:
- Part A – Hospital Coverage
- Part B – Medicare Insurance
- Part C – Medicare Advantage
- Part D – Voluntary (Outpatient) Prescription Drug Coverage
As you can see, there are many options for health care coverage with Medicare. Because Medicare can be a complicated program to fully understand, it is best to contact your health insurance provider to tailor a Medicare plan that is best for your individual budget and health concerns.
You have a 7-mounth Initial Enrollment Period (IEP) for Medicare. It includes the month you turn 65, the 3 months before and the 3 months after. It begins and ends a month earlier if your birthday is the first day of the month.
- You should be automatically enrolled in Medicare Part A and Part B if you are receiving Social Security or Railroad Retirement Board benefits when you become eligible. You'll receive your Medicare card in the mail.
- You need to enroll in Medicare yourself if you aren't receiving Social Security benefits when you become eligible. Go to ssa.gov/benefits/medicare to enroll online, or call or visit your local Social Security office.
Both Medicare and Medicaid are government programs. Both programs help people pay for health care. But that's where the similarities end. Medicare is generally for people who are older or disabled. Medicaid is for people with limited income and recources. Medicare is governed by the federal government. Medicaid programs are governed by the states.
Medicaid provides health care coverage for people and families with limited incomes. It may also offer some services not covered by Medicare. Each state creates its own program, so contact your state Medicaid office for more information.
If you qualify for both Medicare and Medicaid, you are "dual eligible." In this case, you keep your Medicaid benefits and may get additional benefits from Medicare. The two programs can work together to cover most of your health care costs.
- Most care outside of the United States.
- Personal expenses while hospitalized, such as a TV or phone.
- Custodial care (care that helps with daily life activities like eating or bathing).
- Long-term care.
- Days spent in a psychiatric hospital beyond certain set limits.
- Hospital days beyond set limits.
- Eye exams, eyeglasses or contact lenses.
- Hearing exams or hearing aids.
- Routine dental care: Dental exams, cleanings and X-rays.
- Most prescription drugs.
- Wellness benefits such as gym memberships.
Part A – Hospitalization Insurance
Medicare Part A helps to cover inpatient hospital care, including care provided by skilled nursing facilities and nursing homes, as well as hospice care and certain home health care expenses.
Part B – Medicare Insurance
Supplies and services needed to diagnose and treat medical conditions are covered under Medicare Part B, also referred to as Medicare Medical Insurance. This includes outpatient care, physician services and services such as occupational therapy, physical therapy, and home health screening services that are not covered under Part A. Some preventative health screening services are also covered under Part B.
Part C – Medicare Advantage
Also known as Medicare Advantage, Medicare Part C enables you to select a health plan though private insurance provider approved by Medicare. Medicare Advantage Part C plans include managed care insurance plans, such as HMOs and PPOs, as well as private, fee-based plans.
Part D – Prescription Drug Benefits (Voluntary and Outpatient)
To obtain Medicare Part D prescription drug coverage, you must be enrolled in a Medicare-approved prescription drug plan. Enrollment in a Medicare Advantage plan that contains drug coverage is another to get prescription drug coverage.
Medigap
To address some of the costs that are not covered by other Medicare plans, you can choose to purchase supplemental Medigap insurance. Medigap is provided by private insurance companies and commonly requires that you first enroll in Part A and B.