Find resources in the United States to help you understand which benefits you and your senior can access.
Understand how Medicare, Medicaid and Veterans Benefits work and how they can help you.
As individuals age, there are often many questions regarding how to pay for care. Many people are surprised to learn that Medicare doesn't pay for long term care. Additionally, people are often unaware of benefits they are eligible for that will assist them with paying for care.
Some programs are implemented on the federal level and therefore remain the same across the country (such as Medicare), whereas other programs vary state by state (such as Medicaid).
Medicare is a federal health insurance program designed for individuals over the age of sixty-five, or for individuals younger than sixty-five with certain disabilities. There are four parts to Medicare: A, B, C and D.
Part A focuses on hospitals. It covers hospital visits and stays up to 100 days, including rehabilitation in a skilled nursing facility. It also covers hospice and limited home health care coverage.
Part B centers on ongoing medical care and covers outpatient care, such as doctor visits, preventative care, rehabilitation and physical therapy. An individual must be hospitalized for three consecutive days in order to receive rehabilitation coverage. There are no restrictions on what doctor you can see, but there is a copay for these visits.
Part C is the Medicare Advantage Plan. These plans are administered by private insurance companies and can be more cost effective than Part B. However, there are limitations on the doctors and service providers an individual can use. This can be challenging, as the average seventy-five-year-old has three or more chronic health conditions and a variety of doctors.
Part D is an optional prescription drug coverage plan. Different options have different fees, copays and deductibles. How much you are responsible for changes depending on how much you have spent. You are responsible for your drug costs until you hit a certain deductible, and at that point Part D kicks in and pays for a large percentage of it. If your prescription bills continue to grow and hit a new level, you are then no longer eligible for this benefit -- you have hit a coverage gap called the "Donut Hole". (This gap is growing smaller due to the Affordable Care Act and the government aims to abolish it completely by 2020.) You are now responsible again for all of your drug costs, until you hit another higher level and Part D comes into effect again and picks up most of the cost.
Get more information on Medicare at the official site.
Medicaid is a joint federal and state program that pays medical costs for low income individuals. It varies state by state and every state has different eligibility requirements for each population that they serve: pregnant women, children, the elderly or disabled individuals. To determine eligibility, you must fall within the income level determined by the state.
Medicaid covers medical care such as physician visits, hospital bills, prescriptions and long term care. It is the largest payer source of long term care and covers two-thirds of all nursing home patients.
If you or a loved one may be eligible for Medicaid, contact an elder law attorney for more information about eligibility in your state. You can also read more on the official site.
Veterans Benefits are monthly benefits that a military veteran or the surviving spouse of a veteran can receive. Learn more about them by reading this article.
In order to receive these benefits, you must be sixty-five or older and honorably discharged. Individuals younger than sixty-five with certain disabilities may also qualify. Benefits are based on income and therefore individuals may not qualify if their income exceeds a certain limit.
The Aid and Attendance benefit is designed specifically for veterans who need assistance with care needs, such as bathing, feeding, dressing, meal preparation, ambulating and medication prompting. The veteran receives a monthly stipend that will help pay for the cost of a caregiver to assist with their care needs.
To apply for assistance or determine if someone is eligible, visit www.VA.gov.
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