THE US MEDICARE AND MEDICAID SERVICES

What is the Medicare Program?

Medicare is a health insurance program that offers medical care services to the following categories:

• People aged 65 and over

• Individuals under the age of 65 with certain disabilities

• People of all age groups with kidney failure in its final stages (ESRD); permanent kidney failure that requires washing or kidney transplant. 

What Are the Parts of the  Medicare Program Plan?

The Medicare Program original plan is a health insurance coverage plan based on the principle of paying fees for getting services, and it consists of two parts: Part A (Hospital Insurance) and Part B (Medical insurance).

Part A covers the following:

  • Care for in-hospital patients
  • Care from trained and skilled nursing staff
  • Care for the elderly
  • Home medical care

You don’t usually pay a monthly premium fee for Part A of insurance if you or your wife pay taxes for a certain period of time during your tenure.

This is sometimes known as Medicare A without installments.

Medicare Program

 If you’re not eligible for part A without installments you may be able to buy Part B.

Part B covers The following: 

  • Services provided by doctors and other health care providers 
  • Outpatient care
  • Home medical care
  • Durable medical equipment (DME) such as wheelchairs, crutches, hospital beds, and other equipment.
  • Many preventive services (e.g. tests, vaccinations, vaccines, visits and annual ”Health Safety” examinations.

Most individuals pay the regular monthly premium for the part B

NOTE: Individuals must pay the original plan (Original Medicare) in return for many health care services and medical equipment but not all. Supplementary insurance of the Medicare Program, known as Medigap, which is sold through private companies, can help you pay for some of the remaining health .care costs, such as co-payment amounts, insurance participation amount and deductibles, (Medigap) in the name of

 Part C: This part is an alternative to the Original Medicare Plan and it includes the services of Part A Plan, Part B Plan, and Part D Plan.

The costs of some plans may be lower than the costs of the Original. Medicare plan. Most plans provide additional benefits not covered by the Original Medicare program plan such as vision, hearing, and dental services.

Part D: 

  • This part of the Medicare program covers the costs of prescribed drugs and medications including many recommended vaccines.
  • These plans have an annual limit on the costs you pay for medical services.
  • They may help reduce your drug costs and may protect you from higher costs in the future.

Note: If you have limited income and limited resources, you may be eligible for assistance to pay some of the costs of drug coverage and health care. 

 Visit the website: www.medicare.gov

Or call the MEDICARE number: (1-800-633-4227) 1-800

For more information about programs that can help you pay for your costs, phone text users can call: 1-877-486- 2048

What’s The Medicaid Program? 

Medicaid is a joint program (between the state and the federal government) that helps pay medical costs if you have limited income and resources and you meet other requirements. The people involved in the Medicaid plan may get on coverage for services that the Medicare program plan may not cover or those which may be partially covered such as home nursing services, personal care services, and home and community services, oral and dental services, vision services, and hearing services.

To be eligible to participate in a state’s Medicaid program plan, you must be a resident in that state, a US citizen, or have qualified immigration status. Each state has its own eligibility policies and fees 

If you are eligible to participate in the Medicaid program in your state, you’ll automatically be eligible for additional Medicaid assistance in the payment of prescriptions for drugs and medications within the Medicare program (Part D).

You may be eligible to join the Medicaid program if your income is limited and belongs to any of the following categories:

Medicaid Program
  • People aged 65 and over
  • Children under the age of 19
  • Pregnant women
  • Persons with disabilities
  • Adult or parent who cares for a child
  • Adults without parents (in certain states)

In many states, more parents and adults can get medical coverage now. So,

if your application has ever been rejected, you can try again as you may be eligible at the moment.

If you’re a participant in the Medicaid Program, you can benefit from the advantages  like medical care such as:  

  • Doctor visits
  • Hospital stay
  • Long-term medical support services
  • Preventive care, including vaccinations or vaccines and mammograms, colonoscopy, and many other services.
  • Prenatal and maternity care
  •  Mental health care
  • Essential medicines
  • Vision and dental care (for children)

If you, or a member of your family, need health care, you must apply to join the Medicaid program. If you are not sure about your eligibility, an officer in your state can study your case and decide on your status. Contact the Medical Assistance Office of the Medicaid Program in your state to see if you are eligible to apply.

Dual Eligibility

Dual eligibility applies to individuals who are eligible for both Medicare and Medicaid programs. If you have full coverage under any of the two programs( Medicaid or Medicare), most of your health care costs will probably be covered.

You can get medical coverage through the Medicare original or premium plan. If you’re a participant in the Medicare Program or the Full Medicaid Plan, Medicare Part D will cover your prescribed drugs, and some other drugs and health care services will be covered by the Medicaid Program. 

  • For more information, please visit HealthCare.gov/medicaid-chip/getting-medicaid-chip 
  • Visit: Medicare.gov/talk-to-someone,  to learn more about the program
  • Or call the number 1.800-Medicare or 1-800-633-4227-Medicare, to obtain the telephone number of the Medical Assistance Office (Medicaid) in your state or for more information about the program.

You have the right to information about Medicare in an easily accessible format such as printing in capital letters, braille system, or as an audio file. Also, you have the right to submit a complaint if you feel you were subject to discrimination.

Please, visit: Medicare.gov/about-us/nondiscrimination/accessibility-nondiscrimination.html, or call 1-800-MEDICARE (1-800-633-4227)  for more information.

 Users of the textphone TTY can call 1-877-486-2048

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