Medicaid B & D
Medicare is the Federal health insurance program for Americans age 65
and older and for certain Disabled Americans. If you are eligible for Social
Security or Railroad Retirement benefits and are age 65, you and your
spouse automatically qualify for Medicare.
Medicare has two parts: hospital insurance, known as Part A, and supplementary medical insurance, known as Part B, which provides payments for doctors and related services and supplies ordered by the doctor. If you are eligible for Medicare, Part A is free, but you must pay a premium for Part B. Now we have Part D and Med Advantage coverage.
Medicare will pay for many of your health care expenses, but not all of them. In particular, Medicare does not cover most nursing home care, long-term care services in the home, or prescription drugs. There are also special rules on when Medicare pays your bills that apply if you have employer group health insurance coverage through your own job or the employment of a spouse.
Medicare usually operates on a fee-for-service basis. HMOs and similar forms of prepaid health
care plans are now available to Medicare enrollees in some locations.
The best source of information on the Medicare program is the Medicare Handbook. This booklet explains how the Medicare program works and what your benefits are. To order a free copy, write to: Health Care Financing Administration, Publications, N1-26-27, 7500 Security Blvd.,
Some people who are covered by Medicare buy private insurance, called “Medigap” policies, to pay the medical bills that Medicare doesn’t cover. Some Medigap policies cover Medicare’s deductibles; most pay the coinsurance amount. Some also pay for health services not covered by Medicare. There are 10 standard plans from which you can choose. (Some States may have fewer than 10.) If you buy a Medigap policy, make sure you do not purchase more than one.
You need to shop carefully before deciding on the best policy to fit your needs. You may get another booklet, Guide to Health Insurance for People with Medicare, Financing Administration, Publications N1-26-27, 7500 Security Blvd., Baltimore, MD 21244-1850.
Another good source of information on the same topic is The Consumer’s Guide to Medicare Supplement Insurance. To order a free copy, write to: Health Insurance Association of America,
555 13th St., N.W., Suite 600 East,
Medicaid provides health care coverage for some low-income people who cannot afford it. This includes people who are eligible because they are aged, blind, or disabled or certain people in families with dependent children. Medicaid is a Federal program that is operated by the States, and each State decides who is eligible and the scope of health services offered.
General Information on the Medicaid program is given in the Medicaid Fact Sheet. For a free copy, write to: Health Care Financing Administration, Publications, N1-26-27, 7500 Security Blvd.,
contact your State Medicaid Program Office.
F. Darrell Lindsey
State Licensed Agent/Broker