Medicare, Medigap, and Medicaid
|What is it?||Federal health insurance program for Social Security recipients. Parts A and B comprise the original Medicare program.
Medicare Advantage (also referred to as Part C) plans are also available. They provide managed care and fee-for-service options through private insurers.
|Medicare supplement insurance issued by private companies.
Typically, individuals who have Medicare Advantage would not need a Medigap plan.
|Joint federal-state need-based health insurance program.
Eligibility requirements and covered services vary from state to state.
|What does it cover?||All or some portion of:
Part A: Hospital and skilled nursing facilities, home health agency care, hospice care, inpatient psychiatric care, and blood transfusions.
Part B: Doctors, outpatient mental health services, therapy, part-time skilled home health care, certain preventative services, and other medical services.
Part C: All the benefits offered by the original Medicare plan. Some offer added benefits such as prescription drugs, eye exams, and hearing aids.
Part D: Prescription drug coverage (optional).
|All or some portion of:
Medical care not covered by Medicare, deductibles, co-payments, and coinsurance; plans may also cover other services such as eye and dental exams.
|All or some portion of:
A broad range of medical services including inpatient and outpatient hospital care, prescription drugs, nursing home care, and skilled care.
|Who is eligible?||Generally, persons age 65 or older, and those with certain disabilities or diseases are eligible for Medicare Parts A and B.
Anyone eligible for Parts A and B is eligible for Part C and Part D.
|Individuals who are enrolled in Medicare Parts A and B.||Individuals who have limited income and resources and who meet other eligibility requirements.|
|What is the cost in 2013?||Part A: Most participants don't pay for this coverage because of prior Social Security covered employment.
Part B: Monthly premium: $104.90 (higher premiums may apply based on income); Annual deductible: $147.00.
Part C: Varies by insurer, state, and plan.
Part D: Varies by insurer, state, and plan.
|Premiums vary by company, region, and plan. There are generally 10 available plans, each offering different levels of coverage. Not all plans are available in every state.||No premium.
Deductibles vary from state to state.
|What does it take to enroll?||If you are receiving Social Security or Railroad Retirement benefits (or are applying for benefits) at or prior to age 65, you will be automatically enrolled in Part A and Part B.
Contact the Social Security Administration to enroll if:
|Purchase a policy from an insurance company.
You can find information on Medigap policies offered in your area by visiting the Medicare website or calling (800) 633-4227.
|Application procedures vary from state to state.
For information, contact the agency responsible for administering Medicaid in your state.