Medicare
Medicare is a federal program that helps senior citizens and some disabled individuals pay for health care. It is divided into four parts: Part A, Part B, Part C and Part D.
Part A is free to eligible recipients and helps pay for in-hospital care. It provides services associated with hospital, hospice, with limited coverage for skilled nursing care and home health care.
Part B is the medical insurance portion of Medicare, which covers physician services, outpatient hospital care and many other services typically covered under health insurance plans. Individuals who choose to enroll in Part B must pay a premium and deductibles, co-payments or coinsurance may apply to certain services.
Part C referred to as Medicare Advantage, is where you can elect to purchase coverage from a private health insurance company that has contracted with the federal government to offer Medicare benefits through their own policies. Insurance companies that do so are able to offer Medicare beneficiaries health coverage not only through private fee-for-service plans, but also through managed care plans (such as HMOs) and preferred provider organizations (PPOs).
Part D is an optional coverage purchased to help cover the cost of prescriptions. Premiums are subsidized by the government so that you pay only a portion of the actual cost of the program. It is available regardless of your income, illness or cost of drugs.
Medicare Supplement Insurance
Medicare supplement insurance, often called Medigap policies, help fill the gaps in coverage left by Traditional Medicare (Medicare Part A and Part B). Medigap is available in standardized plans with each plan providing a set of standard benefits to cover some or all of the co-payments, deductibles or other charges associated with Medicare benefits.
If you are still working when you become eligible for Medicare, or if you have retiree health benefits from your employer, check your plan before buying Medigap insurance because you may not need a separate Medigap plan.
Making the right choices concerning your Medicare coverage can be confusing. For answers to questions about Medicare, call the Medicare Choices Helpline at (800) 633-4227.
Medicaid
Medicaid is often confused with Medicare. Medicaid is a joint federal/state public assistance program that pays for health care for individuals with limited income and resources. Unlike Medicare and other federal programs, Medicaid does pay for custodial nursing home care. Each state sets its own standards of service provided and administers the program under broad federal guidelines. These rules are complex and vary from state to state, so check with your state Medicaid office to learn about the rules in your state.
Your children may also be eligible for health insurance under Medicaid or the State Children’s Health Insurance Program, a federally funded program to provide health insurance for children in families whose income is too high to qualify for Medicaid but who cannot afford private health insurance.
For more information about Medicare and Medicaid, visit the following Web site: www.medicare.gov.
The USAA Educational Foundation publication, Making Medicare Choices, offers more information.
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