Medicare and Medicaid

Medicare is a health insurance program for people aged 65 and older.  People who have disabilities, permanent kidney failure, and Lou Gehrig’s disease can also qualify for Medicare.  Medicare does not cover all medical expense or the cost of long-term care.

Getting Medicare

You can apply for Medicare through Social Security but the program is run by the Centers for Medicare and Medicaid Services.  Medicare is funded in part through workers payroll taxes and premiums deducted from Social Security checks.

Medicare Coverage and Benefits

1) Part A – hospital insurance that helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care; 

(2) Part B -- that helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance;

(3) Part C -- Medicare Advantage plans are available in many areas are HMO organizations; and

(4) Part D -- Prescription drug coverage that helps pay for medications doctors prescribe for treatment.

What is Medicaid?

Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources.  Each state has its own rules about who is eligible and what is covered under Medicaid.  Some people qualify for both Medicare and Medicaid.  Contact your local medical assistance agency, social services or welfare office for more information. (See more on How to Qualify for Medicaid).

Medicare and Medicaid Appeals

There is an appeals process if you believe you have been unfairly denied benefits or coverage for a medical condition under Medicare and Medicaid.  Medicare and Medicaid are health insurance programs with complicated requirements.  Seek legal assistance for help with the appeals process.  Some individuals may be eligible for free legal assistance depending upon their income.