Medicare / Medicaid is So Confusing

New benefits and plans are emerging every year.

Medicare / Medicaid is So Confusing

New benefits and plans are emerging every year.

Learn About The Insurance
Options Available To Seniors
and Disabled Americans

Health insurance is a complicated issue. Commercial insurance options, for people under the age of 65, range from employer sponsored benefits to individual policies through the health information exchange. Policies range from low-cost premium and high out-of-pocket deductibles and co-payments to high-cost premium with lower cost deductible and co-payments. Government programs for people who qualify for low-income earners and families called Medicaid. Medicare covers people 65 years and older and special groups of people with disabilities. Lastly, the active military and veterans receive care through the Veterans Administration and Tricare. The world of health insurance is confusing. This page is filled with details about the options.

Be Aware

Medicare plan enrollment happens once a year

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read between the lines

The Risk

Not every Medicare and Medicaid provider offers the same level of service.

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emotional pain hurts too

Smart Solutions

Care coordination requires effective communication

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knowledge is power

Find Services

Know your rights and benefits

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you’re not alone

Shop for Products

Check out the great products for healthcare at home.

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find comfort

Empower Others

Here are some tips on how you can brighten someone’s day.

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spread the love

$899.9B

Medicare income last year

76M+

receive Medicaid sponsored health services

18.4%

people with Medicare benefits nationwide

Overview

Medicare

Medicare is a Federal Government health insurance program that pays some medical costs for people age 65 and older, and for all people with late-stage kidney failure. It also pays some medical costs for those who have gotten Social Security Disability Income (discussed later) for 24 months. It does not cover ongoing personal care at home, assisted living, or long-term care.

Part A

Medicare

  • Hospital costs after you pay a certain amount called the “deductible”
  • Hospice Care in the last 6 months of life
  • Short stay in a nursing home to get care for a hospital-related medical condition

Part B

Medicare

  • Some preventive services, such as flu shots and diabetes screening
  • Part of the costs for doctor’s services, outpatient care, and other medical services that Part A does not cover

Part D

Medicare

  • Some medication costs

Overview

Medicaid

Some people may qualify for Medicaid, a combined Federal and State program for low-income people and families. This program covers the costs of medical care and some types of long-term care for people who have limited income and meet other eligibility requirements. Who is eligible and what services are covered vary from State to State.

Notes from the Author

Program of All-Inclusive Care for the Elderly (PACE)

Some States have PACE, Program of All-Inclusive Care for the Elderly, a Medicare program that provides care and services to people who otherwise would need care in a nursing home. PACE covers medical, social service, and long-term care costs for frail people. It may pay for some or all of the long-term care needs of a person with Alzheimer’s disease. PACE permits most people who qualify to continue living at home instead of moving to a long-term care facility. You will need to find out if the person who needs care qualifies for PACE. There may be a monthly charge. PACE is available only in certain States and locations within those States.

State Health Insurance Assistance Program (SHIP)

SHIP, the State Health Insurance Assistance Program is a national program offered in each State that provides counseling and assistance to people and their families on Medicare, Medicaid, and Medicare supplemental insurance (Medigap) matters.

Department of Veterans Affairs

The U.S. Department of Veterans Affairs (VA) may provide long-term care or at-home care for some veterans. If your family member or relative is eligible for veterans’ benefits, check with the VA or get in touch with the VA medical center nearest you. There could be a waiting list for VA nursing homes.

Social Security Disability Income (SSDI)

This type of Social Security is for people younger than age 65 who are disabled according to the Social Security Administration’s definition.

For a person to qualify for Social Security Disability Income, he or she must be able to show that:

  • The person is unable to work
  • The condition will last at least a year
  • The condition is expected to result in death

Monica Stynchula – CEO / REUNIONCare, Inc.