The federal government program we know as Medicare provides health care to individuals over age 65 and others with disabilities and specific illnesses. Those who qualify for Medicare may not be able to afford the monthly payment or the co-payment. State and federal programs assist low-income individuals with the payments necessary to use or continue coverage, or a part of it.
Medicare provides medical insurance through the federal government to qualifying persons. Individuals with end-stage renal disease or amyotrophic lateral sclerosis qualify for Medicare at any age. Those receiving Social Security disability benefits qualify for Medicare after 24 months. If you have worked and paid 10 years or 40 credits of Federal Insurance Contributions Act taxes for Social Security and Medicare, you qualify for Medicare at age 65.
Medicare has four sections that provide different coverage for medical needs. Part A is hospitalization insurance; Part B covers medical outpatient care, such as doctor visits and diagnostic tests. Part C is Medicare Advantage that works like a preferred provider or health maintenance organization to give you better value. Part C may cover both Part A and Part B. Part D is prescription drug insurance to help pay for medication.
States provide Medicare assistance to qualified low-income residents. Proof of low income is required. Programs differ, and some states assist with monthly premium payments while others help with deductibles or coinsurance amounts. States change the parameters and program requirements periodically, so it is essential to inquire at the nearest Social Security or state health and human services office for current information.
Low Income Subsidy, operated through Centers for Medicare and Medicaid Services, lowers the cost of prescription drugs for low-income individuals who qualify. This program assists with payment of monthly premiums, yearly deductibles and prescription co-payments and may help with the coverage gap. SSI recipients with Medicare qualify automatically, as do some other classes of individuals such as Medicare Savings Plan recipients. Some applicants must work through the Social Security Administration to access this program. Contact your local Social Security office and ask about low income subsidy.
The Extra Help and the Medicare Savings programs operate at the state level to provide assistance for Medicare payments. Medicare Savings Programs help qualifying individuals pay for Medicare Part B medical care premiums. The Medicare Savings Program may pay if you have Medicare Part A premiums and also help pay Part A and B deductibles and co–payments. Pharmaceutical assistance programs operated by states or pharmaceutical companies also assist low-income Medicare recipients with drug costs.
- Centers for Medicare and Medicaid Services; Limited Income and Resources: Overview; September 2010
- Social Security Administration; A New “Twist” in the Law Makes It Easier Than Ever to Save on Your Prescription Costs; February 2011
- Medicare; Help with Medical and Drug Costs
- Social Security Administration; What You Need to Know When You Get Social Security Disability Benefits; June 2010
- Social Security Administration; Medicare; January 2011
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