Q. What is Medicare?
A. Medicare is health insurance offered by the federal government to most people who are 65 and older, some people under age 65 who have disabilities and everyone who suffers from End Stage Renal Disease. Medicare Part A is the original Medicare insurance coverage. It helps cover your inpatient care in hospitals, critical access hospitals and skilled nursing facilities. It also covers Hospice care and some home health care.
Q. Who is eligible for Medicare?
A. Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).
Q. How many parts does Medicare have?
A. There are four parts to Medicare: "Part A", "Part B", "Part C", and "Part D".
Q. What services does Medicare Part B cover?
A. It is a supplemental insurance for people who qualify for Medicare and have elected the benefit. Medicare Part B helps cover your doctors’ services, outpatient hospital care, and some other medical services that Medicare Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Medicare Part B helps pay for these covered services and supplies when they are medically necessary.
Q. What does Medicare Part C?
A. These are the Medicare Advantage Plans (usually an HMO or PPO) offered by insurance companies to take the place of Medicare Part A insurance coverage. Individuals elect to sign up for these plans which automatically dis-enrolls them from the Medicare program.
Q. What is Medicare Part D?
A. It is the newest addition to the Medicare program. Medicare Part D is a prescription drug benefit. You must enroll in Medicare before you can apply for Medicare Part D.
Q. Does Medicare cost any money to be enrolled?
A. Most people do not have to pay for Medicare Part A. If Medicare Part B coverage is elected, then most people will pay a monthly fee.
Q. What is a Qualified Medicare Beneficiaries (QMB) program?
A. If you are entitled to receive Medicare Part A or are disabled and have limited income, you may be eligible for the QMB Program. If you're eligible your state Medicaid program will pay for your Medicare Part B premium, Medicare Part A and Part B deductible and coinsurance.
Q. Who is eligible for QMB?
A. Although the rules may vary from state to state in general, you must meet the following in order to be eligible for the QMB program.
Q. If I have QMB Medicaid in the community, does that entitled me to Medicaid in long-term-care.
A. No, you must re-apply Medicaid coverage that covers long term care room and board after you have entered the facility.