Medicare or Medicaid

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Medicare

Medicare is a health insurance coverage which is handheld by the Social Security Office. It has two parts: Part A is a Hospital Insurance and Part B is a Supplementary Medical Insurance (outpatient).

Part A: Pays most costs of hospitalization, certain related impatient care, skilled nursing facility care, and home health services. These benefits are usually free to those who are eligible. A deductible applies to each coverage period.

Part B: Covers doctors’ fees and most ourpatient services. A mothly premium s required unless the person has a Medicare Cost Sharing Program or participates in a Medicaid Program. There is a $100 annual deductible and a 20% co-pay.

Part D: Medicare Prescription drug coverage.

Who is Eligible?

You may be eligible at age 65 if:

  • You are a U.S. citizen or a resident alien who has lived in the U.S. for five years
  • You are eligible for any type of monthly Social Security benefit
  • You or your spouse had Medicare-covered government employment

You may be eligible before age 65 if:

  • You have a disability and received Social Security Disability for at least two years
  • You have end-stage renal failure
How do I apply?

You must apply with your local Social Security Office.

Or Medicaid?

Medicaid is medical assistance for low-income families, children, senior citizens and disabled persons. Each medical program has its own rules. The rules are established by both Federal and State guidelines. Medicaid covers most medical services including prescriptions, unless you are eligible to enroll in.

Medicare Part B: There are also programs which pay for your Medicare Part B premium.

Who is eligible?

To be eligible for Medicaid you must meet the following requirements. You must:

  • Meet criteria program rules
  • Be a citizen or qualified alien (unless they are applying for emergency services ony)
  • Meet income and asset limits
How do I apply?

You may apply at any time of the Department of Workforce Services Offices. There are also eligibility workers in many hospitals and clinic throughout the State. You may apply in person or by mail.

Medicaid does not have an open enrollment period as there is with Medicare and other insurances, so you may apply at any time.

Should I apply for Medicare or Medicaid?

You should apply for Medicare benefits as soon as you become eligible. Social Security applies premium penalties if you do not take the Medicare benefit when you become eligible for it.

You may have the need to have both Medicare and Medicaid Because Medicare does not pay for some services, you may want to have Medicaid which does cover additional services. Medicaid also pays the Medicare Part B premium for any Medicaid recipient.

Medicare Cost Sharing:

Medicare Cost Sharing programs are available to anyone who is eligible for Medicare Part A and meets income and resource limits. These cost sharing programs pay for the Medicare Part B premium. One of the programs also pays the Medicare co-pays and deductibles. You can apply at any office which takes Medicaid applications.

For the Office closest to you please call:

Social Security 1-800-772-1213
Medicaid 1-800-662-9651

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