There are two main programs administered by the government that offer benefits to senior citizens – Medicare and Medicaid. Medicare is available for all senior citizens age 65 or older. Those under age 65 with certain disabilities may also be eligible for Medicare. If you are not a U.S. citizen, you must have entered the U.S. lawfully at least five years prior to receiving Medicare benefits. Medicaid is for people with limited income.
Medicare has two parts. Part A is the hospital insurance and Part B is the medical insurance.
Medicare Part A can pay for home health care if the patient meets certain requirements. Part A is set up mainly to pay for care in a hospital or skilled nursing facility, or by hospice. Depending on the amount of Medicare taxes paid by the patient and their spouse over their lifetimes, they may not have to pay a monthly fee for Medicare Part A. Otherwise, the patient may have to enroll and pay a premium.
Medicare Part B is the medical portion which helps pay for medically-necessary doctors’ services and other patient care. Part B can also pay for some preventative services (like flu shots) or some services to keep certain illnesses from getting worse. The standard monthly premium for Medicare Part B was $96.40 in 2008.
You have two main options in how you get your Medicare coverage.
You can choose traditional Medicare coverage, which is managed by the Federal government. This plan provides Medicare Part A and Part B coverage. The recipient can choose to have either Part A or Part B or both. There is a mandatory deductible, and usually coinsurance charges for each time one gets service. A Medicare supplemental insurance policy known as “Medigap,” can also be purchased. This helps pay for some of the “gaps” such as co-payments, coinsurances, and deductibles.
Medicare Advantage Plans, offered by Medicare-approved private insurance companies (called Part C) is another option. They generally provide services in addition to Part A and Part B services. Co-payments, co-insurance, and deductibles are likely to be less, but you pay a monthly premium.
Medicare Part D is available for senior citizens with limited income to help pay for prescription costs.
Medicaid is a health insurance program designed for people with low-income. It is funded by both the Federal and state government. Each state administers the program for its residents. Rules for eligibility include the potential recipient’s income and assets. Each state may have slightly different rules for determining financial need and other eligibility requirements.
If the senior citizen you are caring for has limited income, you should apply to find out if he or she is qualified. Find a qualified caseworker in your state to help you with the application process. You may have to pay a co-pay for certain medical services, depending on your state’s policies.
Medicare and Medicaid will pay for most of the medical expenses, including nursing home care, for those who qualify.