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Senior Living

2003-04-01 11:29:00

Differences between Medicare & Medicaid

:  I hear people talk about Medicare and Medicaid. Are these different programs?

ANSWER:  Yes. Congress created both Medicare and Medicaid in 1965. The programs have different eligibility requirements and different benefits. Many people confuse Medicare with Medicaid because the names sound alike and the programs are available to some of the same groups of people. QUESTION:  How does eligibility for two programs differ? ANSWER:  Both Medicare and Medicaid are directed mostly to those age 65 or older and many younger people with disabilities. Medicare is available regardless of income and resources. Medicaid eligibility is available only to individuals who meet certain income and resource limits. Medicaid has many different programs. Each has its own income and resource limits. A Medicare beneficiary with limited income and resources may also be eligible for Medicaid assistance. QUESTION:  What is covered by Medicaid? ANSWER:  Medicaid is an assistance program that pays certain medical and health care costs for persons who qualify. Medicaid has many different programs. Benefits vary depending on the program. Some Medicaid programs pay for services not covered by Medicare such as prescription drugs, dental care, eyeglasses, hearing aids, and long-term care. Other Medicaid programs are more limited and pay only for Medicare premiums, deductibles and coinsurance. Generally, someone eligible for Medicaid does not need Medicare supplement insurance. QUESTION:  I need help and think I qualify for Medicaid. Where do I go to apply? ANSWER:  Kansas' Medicaid program is funded by the federal and state government and is managed by the Kansas Department of Human Services (DHS). To determine if you qualify for Medicaid, contact your local county office of human services. The phone number for your local office is available in the "local government" section of your telephone directory. To receive assistance in completing the paperwork, contact your local Area Agency on Aging. QUESTION:  What are the benefits under Medicare? ANSWER:  Medicare consists of two parts, Part A and Part B. Medicare Part A is hospital insurance and is free to most who are eligible for Medicare. Medicare Part B is medical insurance and costs $58.70 per month for 2003. Medicare covers medically necessary services for illnesses and injuries. Medicare rules determine how much can be charged for covered services. A Medicare beneficiary is responsible for deductibles, co-insurance, and services not covered such as prescription drugs, annual physicals, routine vision services or hearing exams. Most Medicare beneficiaries have supplemental insurance to cover some of these costs. QUESTION:  Where do I get answers to questions about Medicare? ANSWER:  Whether you are new to Medicare or have had Medicare for a long time, you may have questions about what is covered. Much information is available on the Internet at http://www.medicare.gov/. You can also get a free copy of the Medicare Handbook by calling the Social Security Administration at 1-800-772-1213. For coverage and claims questions on Medicare Part A (hospital insurance), that covers hospitals, skilled nursing facilities, home health visits, or hospice services; and Medicare Part B, that covers such things as doctors' services, ambulances and lab tests, durable medical equipment, such as a walker or oxygen equipment, go to http://www.medicare.gov/ QUESTION:  Does Medicare cover the cost of prescription drugs? ANSWER:  Currently, the answer is no. The Senior Health Insurance Information Program (SHIIP) may be helpful by helping you to find discounts on medications.