Learning more about Medicare, Medicaid
News and Views from Rita
We are not afraid of the ides of March anymore, since the IRS beckons us now to the ides of April.
For the many questions I have been asked about the differences between Medicare and Medicaid, I will explain.
Medicaid is a joint federal and state program that helps with medical costs like nursing home care and personal care services, for some people with limited income and resources. You may be eligible for extra help paying for Medicare prescription drug coverage (Part D), even if your income exceeds Medicaid income levels, under the spend down rules if you are medically needy.
Medicare is a federal program that you have paid into whenever you receive a salary. If you have ever wondered what the deduction of FICA means, it is the Federal Insurance Contributions Act, which is imposed on both employees and employers and it is the program that funds both Social Security and Medicare.
In Alaska, here are three parts to Medicare. Part A covers you when you are admitted to a hospital -- you must ask if you are really admitted or just in for observation, since Medicare will not cover you if you are not an admitted patient.
Part B, covers almost everything medical that occurs outside of a hospital, however you should be aware that Medicare will only pay 80 percent of those costs. There is a program called Medigap, which is an insurance which supplements Medicare. You need Medigap to cover the deductibles for Part A and Part B.
The third part to Medicare is Part D, which is another insurance that covers your medications. Enrollment for this program is from Oct. 15 each year until Dec. 7, and you must enter all your medications into a computer program to see which plan is the best for you.
If you read the “Medicare and You” brochure, please be aware that we do not have Part C Medicare Advantage Plans in Alaska.
To sum up, once you are on Medicare, you are almost required to buy into several other insurance programs so that you will be almost fully covered, healthwise.
It is my opinion that there are too many insurance companies involved with our health care and there must be another way, as most of the world’s other advanced countries have discovered.
Here are some statistics that you may not have thought about, the costs of health care in Alaska:
• Nursing home annual fee, $250,755 (highest cost in USA)
• Home health care average daily rate, $168
• Assisted living care annual cost, $66,000 in Anchorage and $85,500 in Fairbanks.
Here are some programs that might assist you, depending on your income:
Medicare Savings Programs (MSP) are programs in your state that help pay your Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance and copayments, and Medicare prescription drug coverage costs.
You may qualify for the Qualified Medicare Beneficiary (QMB) program, Specified Low-Income Medicare Beneficiary (SLMB) program, Qualifying Individual (QI) program, or Qualified Disabled and Working Individuals (QDWI) program, even if your income and resources are higher than the state limits.
If you want to know your eligibility for any of these programs, you should apply for them at your nearest Public Assistance Office. It can never hurt to apply.
Rita Hatch is an Older Persons Action Group board member and volunteers for OPAG’s Medicare assistance program. Contact her at 276-1059 in Anchorage or toll-free statewide at 1-800-478-1059. Her email address is firstname.lastname@example.org.