Medicare is a very useful health program for seniors, but it can be very confusing and overwhelming to get through the application process correctly. If you have questions about whether you qualify for Medicare, what coverage you would most benefit from, or if you need Medicare enrollment help, contact the Area Agency on Aging of West Central Arkansas. We offer free medicare counseling for all senior citizens in the area.
We’ll go over your medicare eligibility and benefit options and help you make the decision that makes the most sense for your specific circumstances.
What Is Medicare?
Medicare is health insurance for:
- People 65+ years old
- People with certain disabilities
- People with end-stage renal disease (ESRD)
Medicare has four “parts”. These are basically different plans that cover different types of health issues and care needs.
Part A of Medicare covers:
- Home health care
- Hospice care
- Nursing facility care
- Inpatient care in a hospital
If you (or your spouse) paid Medicare taxes while working for a certain period of time, you likely won’t have to pay a premium for Part A Medicare.
Part B of Medicare covers:
- Outpatient care
- Home health care
- Durable medical equipment (DME)
- Preventative health services
- Services from doctors and health care providers
Most people will have to pay a premium for access to Part B Medicare.
Part C Medicare is often referred to as “Medicare Advantage”. It’s a bundled plan that usually includes Parts A, B, and D. Sometimes it’s cheaper to choose a bundled plan than to use both A and B parts of Medicare. It may also include dental, vision, and hearing services.
Part D of Medicare is actually run by private insurance companies that follow preset rules from Medicare. Part D helps cover the cost of prescription medications. It can also help lower your drug costs and prevent you from having to pay higher drug costs in the future.
Medicare Eligibility Criteria
To qualify for Medicare:
- You must be 65+ years or older;
- Have a qualified disability; OR
- Have end stage renal disease (permanent kidney failure requiring dialysis or transplant).
After you turn 65, you have a seven-month window around your birthday month to choose your Medicare plan and enroll. You may apply three months before your 65th birthday, during the month of your birthday, or for three months after your 65th birthday.
When you enroll can affect when your coverage starts. So, to avoid a lapse in health care coverage, please contact a medicare counselor at your local Area Agency on Aging to ensure your application is filled out and submitted correctly and on time.
Medicare vs Medicaid
Medicare is a federal program that provides health insurance for senior citizens (ages 65+) and people with disabilities regardless of their income.
Medicaid is administered on both the state and the federal level. It provides health care coverage for those with very low incomes.
It is possible to be eligible for both Medicare and Medicaid. If you are eligible for both programs, you can use both of them. They work together to lower your health care costs and provide comprehensive health coverage.
If you believe you may be dually eligible, contact the Area Agency on Aging of West Central Arkansas for free Medicare counseling. One of our dedicated specialists will walk you through the eligibility requirements and help you complete the appropriate paperwork to apply for Medicare or Medicaid–or both!