Medicare Or Medicaid: Who Should I Call?

Medicare is the federal health care program that provides benefits to those 65 or older or disabled. To be eligible for Medicare, you must have worked and paid the Medicare tax and be a U.S. citizen or  be a U.S. resident. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have original Medicare coverage, you can buy a Medicare supplement policy (called Medigap) from a private insurance company to cover some of the costs that Medicare does not.  A portion of the payroll taxes paid by workers and their  employers cover most Medicare expenses. Most people who have worked and paid the Medicare tax, do not pay a monthly premium for Medicare Part A, but everyone pays a premium for Part B. Medicare currently has a red, white and blue membership card, but the appearance of the card may change next year. Medicare is removing Social Security numbers from Medicare cards next year.  But if you have Medicare, it will say “Medicare” on the card.

Medicare Part A covers hospital stays, skilled nursing facility stays after a hospital stay (but not long term nursing home care), some home health care and hospice care. Medicare Part B helps pay for services from doctors, outpatient care, home health care, durable medical equipment and some preventive services.

You should call Medicare if you have questions about what specific services they cover and what the coverage is. Medicare’s toll-free number is 1-800-MEDICARE. You can replace a missing Medicare card by using your my Social Security account on the Social Security website (www.ssa.gov).

Medicaid is a state/federal program run by the state government of the state you live in. It provides hospital and medical services for people with low income and resources. Each state decides who they will cover and what coverage they will offer. If you don’t qualify for Medicare, you would contact the state government for your state to ask Medicaid about eligibility. Use this link to visit your state’s Medicaid site: https://www.medicaid.gov/about-us/contact-us/contact-state-page.html. Questions about services and coverage about Medicaid in your state should be made to your state program.

The Center for Medicare and Medicaid hosts a free community resource to find the answers about Medicare and Medicaid. This community group is called the Senior Health Insurance Information Program (some states have their own name for the program). You can visit this link to find the group in your state: http://www.seniorsresourceguide.com/directories/National/SHIP/.

Sometimes knowing who to call is your best step toward finding the info you need.