Medicare/Medicaid Info

October is the month to review Medicare if needed.

When you turn 65, you become eligible for federal health insurance, called Medicare. You can receive this government benefit, regardless of your income or employment. Medicare is like other health insurances – it has premiums, co-payments and deductibles.

It’s a good idea to understand just what is covered by Medicare and what isn’t. Medicare covers short stays in hospitals or nursing facilities, ambulances, medical aids, prescriptions, therapy, some home healthcare needs and some doctor visits. Medicare will cover up to 100 days in a skilled-nursing facility after a 3-day hospital stay, if you require skilled-nursing services. After the 20th day, there is a significant co-pay that some, but not all supplemental-insurance plans will pay for.

Medicare does not pay for long-term care. Medicaid, another government program, pays for long-term care; however, to qualify for Medicaid you have to meet a means test that looks at your health, assets and income before you qualify—your assets cannot exceed $2,000 and your income in 2016 cannot exceed $2,199 per month. If your income exceeds that limit, you can still qualify by setting up a Miller Trust. If you have a spouse, there are provisions in the law that allow your spouse to keep your home, one car and ½ your liquid assets up to $119,220, so that your spouse is not impoverished while paying for your care.

The initial enrollment period for Medicare begins three months before your 65th birthday, includes the month you turn 65, and ends three months after you turn 65. If you miss your Initial Enrollment Period, you can sign up between January 1 through March 31 each year but it may include a late penalty. October is a good time to review your plan. There is also an Annual Election Period from October 15 through December 7, when you can consider whether you would benefit from enrolling in or changing a Medicare Advantage Plan or a prescription drug plan.

Understanding the laws and knowing what Medicare and Medicaid cover, will allow you to get the most for your money.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a Senior’s legal, financial or healthcare needs, please call us.