Paying for Senior Care

The Internet is rife with resources on how to pay for your or a loved one’s senior healthcare. To help ease your web search overload, we have compiled some helpful explanations on what Medicare and Medicaid covers when it comes to senior health care. Follow the links for additional information – and if you have any questions please do not hesitate to contact us. The Avamere Family of Companies are here to help!iStock_000009129801Large (Small)

Medicare:

Medicare is a health insurance program for:

  • people age 65 or older
  • people under 65 with certain disabilities

Medicare Parts A & B (aka: Original Medicare), is:

  • paid for over your lifetime through payroll taxes (Part A only)
  • provided by the Federal Government
  • paid for in conjunction with monthly premiums and co-pays (Part B only)

Medicare Parts A & B (aka: Original Medicare), can help cover, when certain criteria are met:

  • inpatient care in hospitals
  • skilled nursing facility care
  • hospice care and some home health care
  • some of the services of physical, occupational, and speech therapies
  • outpatient and doctors’ services

Medicare Part C (aka: Medicare Advantage), is:

  • a combination of Medicare Parts A & B, and potentially Part D
  • administered through a private provider organization
  • a potential reduction of out-of-pocket costs
  • available only if you qualify for Parts A & B
  • a away to cover additional benefits and services

Medicare Part D (aka: Medicare Prescription Drug Coverage), can

  • be a standalone drug plan to add to your Medicare coverage
  • be offered through the government or a private insurer
  • can offer low or $0 co-pays and deductibles
  • can limit out of pocket costs

Medicare Supplement Insurance (aka: Medigap), can

  • help with expenses not covered by Medicare Parts A & B
  • be offered through a private insurer
  • vary in cost depending on the provider

There is a wealth of information on Medicare and what it can do for you. Start with the source at www.medicare.gov to learn more.

Medicaid

Medicaid is a program for individuals with limited income and assets. You may qualify for help with medical costs for care you receive under Medicare. Medicaid is a joint state and federal program that is administered by the state. The programs and benefits under Medicaid can vary from state to state. However, there are Federal mandatory benefit guidelines that must be followed. These include:

  • Hospital and Skilled Nursing services
  • Care services received at a Federally-qualified health center or clinic

If certain criteria are met, you can qualify for Medicare and Medicaid, which makes you “dual eligible” and the two programs could work together to cover most of your healthcare costs.

For information about dual eligible programs, you can call Social Security at 1-800-772-1213, TTY 1-800-325-0778, 7 a.m. to 7 p.m. local time, Monday through Friday, or contact your state Medical Assistance or Medicaid office.