Medicare Educations.html

This section is designed to provide you with basic information about Medicare. Of course, if you have any questions about benefits you may contact our office at (417) 862-0762 and speak with one of our Information and Assistance Staff or call 1.800.MEDICARE or visit them online at www.medicare.gov.

What is Medicare?
Medicare - Part A & Part B
Medicare - Part D - Prescription Drug Coverage
Medicare Advantage Plans
What is Medicaid (or Medical Assistance)?
Medicaid Eligibility
Helpful Reference Forms by SWMOA

What is Medicare?
Medicare is our Country's health insurance program for people age 65 or older, certain people with disabilities who are under 65, and people of any age who have permanent kidney failure. It provides basic protection against the cost of health care, but it does not cover all your medical expenses nor the cost of most long-term care. You can choose one of two ways to get benefits under Medicare: original Medicare or a Medicare Advantag Plan.

There are two parts of Medicare, they are:

Hospital Insurance (also called "Part A" Medicare), which is financed by a portion of your payroll (FICA) tax that also pays for Social Security; and
Medical Insurance (also called "Part B" Medicare), which is partly financed by monthly premiums paid by people who choose to enroll.

You are automatically enrolled in Part B when you become entitled to Part A. However, because you must pay a monthly premium for Part B coverage, you have the option of paying for the coverage or delaying coverage if you are covered by an employee health plan. Each part of Medicare covers different kids of medical costs, has different rules about enrolling, and so on.

Medicare Part D - Prescription Drug Coverage
The Medicare Prescription Drug Program began in January 2006, offering prescription drug coverage for the first time to people with medicare. The coverage is offered through private insurance companies. The Medicare prescription drug coverage pays for brand name and generic medications up to $2,510. Some plans have enhanced coverage.

Everyone who has Medicare is eligible to enroll in a plan. You can enroll during the initial enrollment period, which is three months before and three months after you turn 65. Annual open enrollment is every November 15th - December 31st of each year. If you do not enroll when you are first eligible and you choose to enroll at a later date, you may have to pay a premium penalty, which will be 1% (one percent) for every month you delay enrollment.

Medicare Advantage Plans
Medicare Advantage Plans or sometimes called "Part C", are plans offered by private companies and approved by Medicare to cover Medicare Part A and Part B benefits. They may include drug coverage. Medicare pays an amount of money to the plan each month to take care of you. You must have both parts of Medicare to join one of the plans. They may also offer additional benefits such as vision, dental, hearing, and wellness. You must accept the Part D Medicare drug plan from the Medicare Advantage Plan if they offer one. Medicare Advantage plans are HMOs, PPOs, or PFFS plans. If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan, and are not paid for under original Medicare. If you use a provider outside of your plans network, you may pay 100% of the cost. In addition to the monthly premium, you will pay copays for doctor services, diagnostic services, and hospital services.

What is Medicaid?
Many people think that Medicaid and Medicare are two different names for the same program. Actually, they are two different programs. Medicaid became law in 1965 as a cooperative venture between the Federal and State governments. Medicaid (known as MO Health Net) is a State-run program designed primarily to help those with low income and little or no resources. While the Federal Government helps pay for Medicaid, each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid. Medicaid is the largest program providing medical and health-related services to America's poorest people. Thus, the Medicaid program varies considerably from State to State, as well as within each State over time.

Medicaid Eligibility
To be eligible for Federal funds, states are required to provide Medicaid (Medical Assistance) coverage for most individuals who receive Federally assisted income maintenance payments, as well as for related groups not receiving cash payments. Just a few examples of the mandatory Medicaid eligibility groups are:

Supplemental Security Income (SSI) recipients (or in States using more restrictive criteria - aged, blind, and disabled individuals who meet criteria which are more restrictive than those of the SSI program and which were in place in the State's approved Medicaid plan as of January 1, 1972);
Certain Medicare beneficiaries (described later); and
Special protected groups who may keep Medicaid for a period of time, such as persons who lose SSI payments due to earnings from work or increased Social Security benefits.
Certain aged, blind, or disabled adults who have incomes above those requiring mandatory coverage, but below the Federal poverty level;
Institutionalized individuals with income and resources below specific limits;
Persons who would be eligible if institutionalized but are receiving care under home and community-based services waivers;
Recipients of State supplementary payments.

Helpful Forms Created by SWMOA

All forms will be available on Friday, Nov. 12.

Below are instructions that you can download to help you to use www.medicare.gov plan comparison tool.

Do I qualify for Extra Help? Download chart.
Click below to view plans offered in 2010 for Southwest Missouri.....