MaineCare Planning

The United States government provides many benefits and resources for seniors. Among these benefits is the Medicare health care program. Sadly, many seniors are unaware if they are eligible, and what benefits they may receive.

Medicare is the federally funded health insurance program for people aged 65 and over. Original Medicare consists of two parts: part A, which is your hospital insurance, and part B, your medical insurance.

Part A:

It covers inpatient hospital care, limited home health services, skilled nursing facility care, and hospice care. Furthermore, inpatient hospital care will include services that are critical such as room costs, meals, medications, and nursing services. Home health services become covered if your doctor deems them medically necessary. This usually includes physical therapy services, part-time nursing care, and even medical equipment. If you need the use of a skilled nursing facility coverage will be eligible after a hospital stay of at least 3 days at a Medicare-certified facility. You are eligible for hospice care coverage when your doctor certifies that you are terminally ill with six months or less to live, and you agree to give up treatments to cure your disease; however, Medicare will still cover the costs for comfort treatments.

Eligibility:

Seniors are eligible for Part A benefits if they are age 65 or older, a U.S. citizen or permanent legal resident of five years or more or are already receiving retirement benefits such as Social Security, and disability benefits. In addition, you might have a chance of eligibility without paying a premium if your employment has lasted at least 10 years and have been paying Medicare taxes. You may still enroll in Medicare and pay a premium if you are not eligible for premium-free coverage. With this in mind, it is important to enroll as soon as you meet these eligibility requirements because you may be subject to a late penalty if you delay. If you are already receiving Social Security benefits or benefits from the Railroad Retirement Board, as a result, your enrollment is automatic when you turn 65.

If this is not your situation, you will need to enroll during the Initial Enrollment Period on the Social Security website or enroll at your local Social Security office. Call 1-800-772-1213. The Initial Enrollment Period begins three months before your 65th birthday and continues for seven months.

Part B:

It covers costs relating to treatment outside of a hospital and includes the services and supplies your doctor states are medically necessary to treat your condition. This may include emergency medical services, outpatient care, and even preventative services. Once enrolled in Medicare part B, you may receive a one-time "Welcome to Medicare" checkup which includes preventative disease screenings, vaccinations, and a physical exam.

If you meet the eligibility requirements for the premium-free part A coverage, you are eligible for part B. You may not qualify for part A, however, you may still qualify for part B if you are 65 years or older and a US citizen or a permanent resident for five consecutive years. Part B does require payment of a monthly premium which depends on your income level, however, you can expect your premium to be about $134 per month. You will need to enroll for part B coverage during the Initial Enrollment Period described previously.

Aging in Maine is an Experienced MaineCare Lawyer

In conclusion, Mainecare enables seniors to afford quality health care coverage at a price that might not have been attainable. Therefore, you must be aware of these benefits and take advantage of them as soon as you are eligible.

If you have any questions about the MaineCare Application and eligibility process or are ready to start your Mainecare planning, Aging in Maine can help, please don't hesitate to call our office at (207)848-5600 or check our CONTACT page.