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Can someone please explain MediCare?

Forums General Melanoma Community Can someone please explain MediCare?

  • Post
    djpayn
    Participant

      Hello.

      I have recently been approved for MediCare but I do not understand what MediCare is.

      I was told that I am now recieving MediCare benefits as well as the MediCaid benefts I was previously on.

      What is the difference in the two?

      Any help or personal experinces will help.

      Thank You.

      Hello.

      I have recently been approved for MediCare but I do not understand what MediCare is.

      I was told that I am now recieving MediCare benefits as well as the MediCaid benefts I was previously on.

      What is the difference in the two?

      Any help or personal experinces will help.

      Thank You.

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    • Replies
        Jamietk
        Participant

          They are both government medical plans. Medicaid is based on financial need. Medicare is based on Retirement age, or disability eligibility. I do not know the difference between what they each cover. It doesn't seem to me someone would need two kinds of government benefits (or qualify for both). Then again, some people do have a primary and secondary private insurance plan. So I really don't know if you need to keep both or not, or if you're eligible for them simultaneously.

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          Jamietk
          Participant

            They are both government medical plans. Medicaid is based on financial need. Medicare is based on Retirement age, or disability eligibility. I do not know the difference between what they each cover. It doesn't seem to me someone would need two kinds of government benefits (or qualify for both). Then again, some people do have a primary and secondary private insurance plan. So I really don't know if you need to keep both or not, or if you're eligible for them simultaneously.

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            Jamietk
            Participant

              They are both government medical plans. Medicaid is based on financial need. Medicare is based on Retirement age, or disability eligibility. I do not know the difference between what they each cover. It doesn't seem to me someone would need two kinds of government benefits (or qualify for both). Then again, some people do have a primary and secondary private insurance plan. So I really don't know if you need to keep both or not, or if you're eligible for them simultaneously.

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              Jamietk
              Participant

                They are both government medical plans. Medicaid is based on financial need. Medicare is based on Retirement age, or disability eligibility. I do not know the difference between what they each cover. It doesn't seem to me someone would need two kinds of government benefits (or qualify for both). Then again, some people do have a primary and secondary private insurance plan. So I really don't know if you need to keep both or not, or if you're eligible for them simultaneously.

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                Charlie S
                Participant

                  Medicare Part A covers hospitalization.  Has an annual deductible that must be met before benefits are paid.

                  Medicare Part B covers doctor visits.  Also has an annual deductible that must be met before benefits are paid.

                  Both A&B also have patient co-pays per event in addition to the annual deductibles. 

                  Very generally speaking, Medicare is about an 80/20 policy , which is to say insurance pays 80%, patient pays 20%

                  Most hospitals, but not all doctors accept Medicare because payment limits  for procedures/appointments are typically lower than that of private insurance and you can choose your own medical providers.

                  Medicare premiums for A&B, automatically,  are deducted (about 100 dollars each month) from your social security gross amount.

                  What I am descrbing is straight up Medicare……not Medicare Advantage Plans.

                  Medicare is funded and administered at the federal level and is only available to those 65 or over or classified as disabled by the Social Security Administration.

                   

                  Medicaid, is funded jointly with federal and individual state monies,, but administered solely at the state and local level by Department of Social Service(sine states have different names) 

                   Administrative rules for medicaid differ from state to state, but are based on financial need.based upon strict income and asset levels and the determined poverty levels.

                  If you receive Medicaid, it is considered a secondary insurance to Medicare and thus will pay for what medicare does not cover.  For instance, in my state, Medicaid will cover the annual deductible of Part A&B and lowers per event co-pays to $2.00 as well as paying for the 20% that Medicare does not pay.

                  Medicaid will pay for dental and vision expenses whereas Medicare will not.

                  Medicaid will pay for transportation costs getting to and from medical appointments.

                  Again, this is my state only; the Medicaid payment schedules differ widely from state to state.

                  Usually if you have Medicaid, you qualify for "extra help" as defined by the Social Security Administration which will mean that Medicaid will then pay your Part A&B monthly premiums and will probably pay for a Part D prescription drug plan for you.  That translates into a $100 increase in your monthly net from SS.

                  A HUGE perk is if you are a card carrying Medicare Beneficiary, you are also eligible to move into decent and affordable housing.  It is NOT public housing/projects, but there are again strict income/asset standards.

                  I live in really nice and safe apartment that is privately owned, but subsidized,and receive a hefty rental discount.  62 & disabled complexes usually have a wheelchair and house logo at the bottom of their signage.

                  Again, this is very GENERAL overview, but hopefully highlights the difference of benefits and services.

                  Hope this helps.

                  Charlie S

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                  Charlie S
                  Participant

                    Medicare Part A covers hospitalization.  Has an annual deductible that must be met before benefits are paid.

                    Medicare Part B covers doctor visits.  Also has an annual deductible that must be met before benefits are paid.

                    Both A&B also have patient co-pays per event in addition to the annual deductibles. 

                    Very generally speaking, Medicare is about an 80/20 policy , which is to say insurance pays 80%, patient pays 20%

                    Most hospitals, but not all doctors accept Medicare because payment limits  for procedures/appointments are typically lower than that of private insurance and you can choose your own medical providers.

                    Medicare premiums for A&B, automatically,  are deducted (about 100 dollars each month) from your social security gross amount.

                    What I am descrbing is straight up Medicare……not Medicare Advantage Plans.

                    Medicare is funded and administered at the federal level and is only available to those 65 or over or classified as disabled by the Social Security Administration.

                     

                    Medicaid, is funded jointly with federal and individual state monies,, but administered solely at the state and local level by Department of Social Service(sine states have different names) 

                     Administrative rules for medicaid differ from state to state, but are based on financial need.based upon strict income and asset levels and the determined poverty levels.

                    If you receive Medicaid, it is considered a secondary insurance to Medicare and thus will pay for what medicare does not cover.  For instance, in my state, Medicaid will cover the annual deductible of Part A&B and lowers per event co-pays to $2.00 as well as paying for the 20% that Medicare does not pay.

                    Medicaid will pay for dental and vision expenses whereas Medicare will not.

                    Medicaid will pay for transportation costs getting to and from medical appointments.

                    Again, this is my state only; the Medicaid payment schedules differ widely from state to state.

                    Usually if you have Medicaid, you qualify for "extra help" as defined by the Social Security Administration which will mean that Medicaid will then pay your Part A&B monthly premiums and will probably pay for a Part D prescription drug plan for you.  That translates into a $100 increase in your monthly net from SS.

                    A HUGE perk is if you are a card carrying Medicare Beneficiary, you are also eligible to move into decent and affordable housing.  It is NOT public housing/projects, but there are again strict income/asset standards.

                    I live in really nice and safe apartment that is privately owned, but subsidized,and receive a hefty rental discount.  62 & disabled complexes usually have a wheelchair and house logo at the bottom of their signage.

                    Again, this is very GENERAL overview, but hopefully highlights the difference of benefits and services.

                    Hope this helps.

                    Charlie S

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