Do I Have Medicare Or Medicaid

I Delayed Medicare At 65 How Do I Enroll Now

If you delayed Medicare coverage past age 65 with creditable coverage, you will need to contact Social Security to enroll in Original Medicare.

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Since you have creditable coverage, you will receive a Special Enrollment Period to enroll in Medicare Part A and Medicare Part B benefits. From there, you can enroll in a Medicare Part D prescription drug plan and Medicare Part C or Medicare Supplement.

However, if you delayed Medicare coverage without creditable coverage, you would need to enroll in Original Medicare during the General Enrollment Period. This is an annual period that runs from January 1 to March 31 each year. Remember, coverage does not begin until July 1 when you enroll during the General Enrollment Period.

Check The Status Of An Application

The Division of Family Resources provides tools to strengthen families through services that focus on prevention, early intervention, self-sufficiency, family support, and preservation.

You can check the status of your application online by clicking on your county of residence or by calling 1-800-403-0864. You will need to have your case number to check the status of your application.

Please remember that your application must be completed and all required documentation submitted before DFR can begin processing your application.

Pursuant to HIPAA and other applicable federal regulations, DFR is committed to respecting the privacy of each client. For that reason, DFR will not share or disclose information about your case without a signed release. You may download the DFR online.

If I Have Other Health Insurance Do I Need Part B

65 Incorporated came across this question from a Medicare beneficiary.

I just heard that if I have other insurance, I need only Medicare Part A. Part B is not necessary. Is this true?

It depends on the type of insurance an individual has. If the insurance is a COBRA or individual policy, or retiree coverage provided by a union or employer, enrollment in both Part A, hospital insurance, and Part B, medical insurance, is necessary. These types of insurance are secondary to Medicare, paying for any covered care after Medicare has paid its share.

But if the insurance comes through current employment of either the beneficiary or his or her spouse with a large employer , Medicare recommends enrollment in premium-free Part A. Part B enrollment is not necessary. When this coverage ends, Medicare provides special periods to enroll in Part B and obtain other coverage, such as a Part D prescription drug plan, a Medigap policy, or a Medicare Advantage plan.

Medicare out-of-pocket costs

Nearly three-fourths of middle-income Boomers under age 65 do not know that Medicare comes with out-of-pocket costs.

Think you know Medicare? Put your knowledge to the test!

Medicare is a national health insurance program that covers millions of people and involves an even greater number of healthcare providers and services. Its size alone invites confusion and misinformation. Find out if you can identify Medicare fact from fiction.

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How Do I Know If I Should Be Dual Eligible

Beneficiaries can find out if theyre eligible for Medicaid by contacting their Medicaid office. An Internet search for Medicaid offices in a beneficiarys state should provide the number to call but beneficiaries should make sure they are contacting a government office before sharing any personal information.

The Centers for Medicare and Medicaid Services also maintains a list of state agencies that oversee Medicaid. Beneficiaries can see if they already have Medicaid by contacting 1-800-MEDICARE and asking whether they receive Extra Help with their prescription drug costs .

Where Did Medicare Come From

On July 30, 1965, President Lyndon B. Johnson signed into law legislation that established the Medicare and Medicaid programs. For 50 years, these programs have been protecting the health and well-being of millions of American families, saving lives, and improving the economic security of our nation.

How many Americans are enrolled in both Medicare and Medicaid?

And there is overlap between the two programs: nearly 10 million low-income seniors and people with disabilities so-called dual eligibles are enrolled in both Medicare and Medicaid.

How do I apply for Medicaid or Medicare?

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Medicaid Is Jointly Financed By States And The Federal Government

Medicaid is financed jointly by the federal government and states. The federal government matches state Medicaid spending. The federal match rate varies by state based on a federal formula and ranges from a minimum of 50% to nearly 75% in the poorest state. Under the ACA, the federal match rate for adults newly eligible was 100% for 2014-2016, phasing down gradually to 90% in 2020 and thereafter . The federal matching structure provides states with resources for coverage of their low-income residents and also permits state Medicaid programs to respond to demographic and economic shifts, changing coverage needs, technological innovations, public health emergencies such as the opioid addiction crisis, and disasters and other events beyond states control. The guaranteed availability of federal Medicaid matching funds eases budgetary pressures on states during recessionary periods when enrollment rises. Federal matching rates do not automatically adjust to economic shifts but Congress has twice raised them temporarily during downturns to strengthen support for states.

Total federal and state Medicaid spending was $577 billion in FY 2017. Medicaid is the third-largest domestic program in the federal budget, after Social Security and Medicare, accounting for 9.5% of federal spending in FY 2017. In 2017, Medicaid was the second-largest item in state budgets, after elementary and secondary education .

Figure 8: Medicaid is a budget item and a revenue item in state budgets.

Medicaid Vs Medicare: You Can Have Both

Posted: January 17, 2020

Medicaid and Medicare. Its hard to think of two words that cause as much confusion.

• Whats the difference between these two government health insurance programs?
• What exactly are Medicaid and Medicare?
• Whos eligible to get Medicaid or to get Medicare?
• And how can some people get both?

Read on to find out the answers to these questions and more.

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Legislation Aims To Make Medicare More Affordable For Lower

The Improving Medicare Coverage Act, introduced in the U.S. House in September by Washington Representative Pramila Jayapal, would do away with cost-sharing and premiums for Medicare beneficiaries with income up to 200% of the poverty level .

This bill, or something like it, would eliminate the current sticker shock that can go along with the transition from expanded Medicaid to Medicare. If you have an opinion on the legislation, you can reach out to your elected officials to speak with them about it.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health marketplace updates are regularly cited by media who cover health reform and by other health insurance experts.

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Can You Have Medicare And Medicaid

The short answer is yes. If you receive coverage from both Medicaid and Medicare, youre a dually eligible beneficiary. If you are dual eligible, you may be enrolled in Medicare and then qualify for Medicaid, or enroll first in Medicaid but later qualify for Medicare. Medicaid assists seniors with limited income and people with disabilities also enrolled in Medicare.

How does dual eligibility work?

Dual-eligible beneficiaries can have:

• Medicare Part AMedicare Part A, also called “hospital insurance,” covers the care you receive while admitted to the hospital, skilled nursing facility or other inpatient services. Medicare Part A is part of Original Medicare.
• Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called “medical insurance,” Part B helps pay for the Medicare-approved services you receive.
• Both Part A and Part B
• Full Medicaid benefits
• State Medicare Savings Programs

Medicare benefits always pay first, and Medicaid benefits assist with costs not fully covered by Medicare.

Medicaid will pay premiums and out-of-pocket expenses for dual-eligible Medicare beneficiaries. Medicare and Medicaid work together to cover costs, including long-term services. If you do not have full Medicaid benefits, Medicare Savings Programs may help cover some of those costs:

Are you eligible for cost-saving Medicare subsidies?

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What’s Covered By Medicaid Vs Medicare

Medicaid and Original Medicare both cover hospitalizations, doctors and medical care. But Medicaid’s coverage is usually more comprehensive, including prescription drugs, long-term care and other add-ons determined by the state such as dental care for adults. In contrast, Medicare means combining multiple parts, so your benefits will be determined by the private Medicare plans that you add on top of Original Medicare.

How To Apply For Family Planning Benefits

• Apply for family planning benefits by completing and submitting the Mississippi Medicaid Family Planning Services Application Form .

For assistance, call the Office of Eligibility toll-free at 800-421-2408. Submit the application as follows:

Mail: MS Division of Medicaid ATTN: Office of Eligibility550 High Street, Suite 1000Jackson, MS 39201-1399

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How Did Medicare And Medicaid Help People

CHANGING LIVES: Medicare and Medicaid provide Americans with access to the quality and affordable health care they need to live happy, healthy and productive lives. Medicaid provides comprehensive coverage to more than 70 million eligible children, pregnant women, low- income adults and people living with disabilities.

Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

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Medicare Vs Medicaid: How Medicaid Works

Medicaid is a need-based joint federal and state insurance program that covers low-income individuals and families. That said, Medicaid coverage can vary significantly from state to state. Thats because the federal government covers up to 50% of each states Medicaid program costs. This means all remaining Medicaid program costs must be paid for at the state level.

Unlike Medicare, Medicaid isnt available to everyone and it has very strict eligibility requirements. To qualify for Medicaid coverage, you must either already be receiving SSI benefits or fit within a mandatory eligibility group. If your financial resources arent limited enough to qualify for SSI, you may still qualify for state-based Medicaid assistance programs. For more information about the updated Medicaid eligibility requirements under the Affordable Care Act , visit the Medicaid.gov website.

While each states coverage varies , the federal government requires that there is coverage for the following services as long as theyre deemed medically necessary.

• Preventive care for children under 21

Who Is Eligible For Medicaid

You may qualify for free or low-cost care through Medicaid based on income and family size.

In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.

• First, find out if your state is expanding Medicaid and learn what that means for you.
• If your state is expanding Medicaid, use this chart to see what you may qualify for based on your income and family size.

Even if you were told you didnt qualify for Medicaid in the past, you may qualify under the new rules. You can see if you qualify for Medicaid 2 ways:

• Visit your states Medicaid website. Use the drop-down menu at the top of this page to pick your state. You can apply right now and find out if you qualify. If you qualify, coverage can begin immediately.
• Fill out an application in the Health Insurance Marketplace. When you finish the application, well tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid and/or CHIP, well let the state agency know so you can enroll.

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If You Have Medicare And Medicaid Ask Us About:

• Free comprehensive physical exams
• Free respite care sessions for members with dementia, including Alzheimers disease*
• Free hearing services including hearing aids*
• A Peoples Health plan ID card thats widely accepted and easy to use

*May not be available with all special needs plans

Many people with Medicaid have faced tremendous hurdles to achieve good health throughout their lives. Weve designed our special needs plans to help lower or remove those hurdles through enhanced benefits and coordinated care.

What Do The Different Medicare Components Cover

Medicare has three different components, and every recipient isnt necessarily entitled to use all of them:

• Hospital: Medicare Part A provides hospitalization coverage as well as paying some hospice, nursing home and home health care costs.
• Medical: Medicare Part B works like most private insurance policies and covers doctors visits, lab work, and visits to the emergency room.
• Prescription Drugs: Medicare Part D helps cover prescribed medication costs. Medicare Part A and B participants are eligible for Part D .

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Medicaid Eligibility And Costs

The federal and state partnership results in different Medicaid programs for each state. Through the Affordable Care Act , signed into law in 2010, President Barack Obama attempted to expand healthcare coverage to more Americans. As a result, all legal residents and citizens of the United States with incomes 138% below the poverty line qualify for coverage in Medicaid participating states.

While the ACA has worked to expand both federal funding and eligibility for Medicaid, the U.S. Supreme Court ruled that states are not required to participate in the expansion to continue receiving already established levels of Medicaid funding. As a result, many states have chosen not to expand funding levels and eligibility requirements.

Those covered by Medicaid pay nothing for covered services. Unlike Medicare, which is available to nearly every American of 65 years and over, Medicaid has strict eligibility requirements that vary by state.

However, because the program is designed to help the poor, many states have stringent requirements, including income restrictions. For a state-by-state breakdown of eligibility requirements, visit Medicaid.gov.

When Medicaid recipients reach age 65, they remain eligible for Medicaid and also become eligible for Medicare. At that time, Medicaid coverage may change based on the recipient’s income. Higher-income individuals may find that Medicaid pays their Medicare Part B premiums. Lower-income individuals may continue to receive full benefits.

What Are My Costs With Dual Eligibility

Dual eligibility can limit individual costs for beneficiaries. For those with Medicare, state Medicaid programs will pay for many cost-sharing and out-of-pocket expenses for medical services. For any service you receive, Medicare pays first and covers all eligible costs. Any qualified costs not covered by Medicare will be covered by Medicaid.

What extra benefits and savings do you qualify for?

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Medicaid Facilitates Access To Care

A large body of research shows that Medicaid beneficiaries have far better access to care than the uninsured and are less likely to postpone or go without needed care due to cost. Moreover, rates of access to care and satisfaction with care among Medicaid enrollees are comparable to rates for people with private insurance . Medicaid coverage of low-income pregnant women and children has contributed to dramatic in the U.S. A growing body of research indicates that Medicaid eligibility during childhood is associated with reduced teen mortality, improved long-run educational attainment, reduced disability, and lower rates of hospitalization and emergency department visits in later life. Benefits also include second-order fiscal effects such as increased tax collections due to higher earnings in adulthood. Research findings show that state Medicaid expansions to adults are associated with increased access to care, improved self-reported health, and reduced mortality among adults.

Figure 7: Nationally, Medicaid is comparable to private insurance for access to care the uninsured fare far less well.

Key Differences Between Medicare And Medicaid

A key difference between Medicare and Medicaid is that one is mainly based on age, and the other is a welfare program for people of all ages with limited financial means.

Medicare assists people 65 or older. In some cases, people under 65 with certain health concerns may be able to sign up. This only applies to the person who qualifies, but not the persons entire family. Medicaid is jointly run by the state and federal governments. It is for people whose eligibility is based on income rather than age or disability. It helps people and families who meet income limits get health care.

You can apply for Medicaid at any time. You do not have to wait for an open enrollment period. In most cases, people who qualify for it may be exempt from the individual penalty. Theres more on that below. When you apply for Medicare outside the time to enroll, you may have a penalty.

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Which Statesuse Their Own Criteria For Granting Medicaid

Theremaining states do not automatically grant Medicaid to persons withdisabilities who qualify for SSI because they use their own criteria fordetermining whether someone is eligible for Medicaid. These states may haveincome limits that are higher or lower than SSIs, different asset limits, ordifferent requirements for what makes someone disabled.

Inmost of these states, however, the income limitsfor Medicaid arent too different from the income limit for SSI . And many of them use thesame resource limit as SSI program, although several have a lower assetlimit than SSI , and a couple states have a higher asset limit .

These states are called 209 states, named after a sectionof the legislation that created the SSI program in 1972. This legislationprohibited states from making their Medicaid eligibility criteria stricter thanthe criteria the states were using in 1972. In these states, you must apply forMedicaid with your states Medicaid agency or health and human services department.

The 209 states are:

Note that Indiana ceased being a 209 state in 2014.

Even though some 209 states have lower income limits than theSSI program, these states have to let Medicaid applicants deduct their medicalexpenses from their income when their eligibility for Medicaid is beingdetermined. This is called spending-down. This means that SSIrecipients with high medical bills will qualify for Medicaid in these states.