Navigating Medicaid Managed Care: Tips for Beneficiaries

Navigating Medicaid Managed Care: Tips for Beneficiaries

Beneficiaries may encounter many new phrases when navigating Medicaid, and “managed care” may seem confusing at first. However, the underlying concepts are quite simple – and it may only take a few minutes to become confident about how managed care works. Simply put, managed care refers to the manner in which your loved one receives healthcare services. The government refers to this as a “health care delivery system” that involves budgeting, quality control, and other organizational steps. The type of managed care depends on your home state, and it may be difficult to create a targeted strategy without help from an experienced elder law attorney

What Exactly is Managed Care, Anyway?

Managed care is the method by which states provide eligible people with Medicaid benefits. The process involves contracting a private insurance company to provide health care services, and the company receives a certain amount of money each month in return.

Although this might seem pretty simple, the Commonwealth Fund notes that managed care can be “extraordinarily complicated” in many areas of the country. Managed care is now the most common way in which beneficiaries receive healthcare benefits. In 1990, only 10% of eligible recipients enrolled in managed care – but now that number has risen to well over 50%. 

Managed Care vs. Fee-for-Service

Fee-for-Service (FFS) is the alternative to managed care. Under FFS, the state compensates the healthcare provider for each service you receive. Many beneficiaries are not aware that there are two different systems when it comes to Medicaid. The differences between these systems are somewhat controversial, with many arguing that one is superior to the other. For example, some point out that under FFS, beneficiaries can choose their own specialists. On the other hand, they could be charged for visiting the ER if it was not a true emergency. While the pros and cons of FFS and managed care represent a completely different topic, beneficiaries should know that they at least know that they may have a choice. 

Understand the Costs Involved

It may help to sit down and discuss the various costs involved with managed care. Typically, managed care plans are cheaper compared to FFS – especially if you choose a Health Maintenance Organization (HMO). These organizations help limit costs while ensuring high-quality care – a difficult balancing act that does not always turn out well. 

In the end, each beneficiary has unique priorities and needs when it comes to healthcare – and it will be difficult to navigate managed care effectively without a solid understanding of your own needs. Remember, part of this planning process involves treatment that you may need at some point in the future. 

It may be helpful to discuss these potential future needs alongside your doctors. Pay close attention to genetic conditions that your family members may have. Consider your current health limitations and how they might degrade or improve in the future. After this discussion, you can take what you’ve learned to your elder law attorney. Your lawyer can then help you determine the most appropriate path forward. 

Understand the Focus on Preventative Care

If you choose managed care, you should understand that this system focuses considerably on preventative care. This is part of the cost-limiting strategy, but it can also help you avoid preventable health concerns. It might seem like this is simply to lower costs for the insurance companies, but all doctors understand that preventing illnesses makes much more sense compared to treating them after they appear. 

As a result, you may be encouraged to get annual check-ups. You might also be encouraged to take vaccines. Screenings may also become more frequent as you age, and this is something you should probably make time for. 

Consider Your Health Network

If you choose managed care, you might want to consider your health network and the quality of healthcare in your specific state. It is no secret that some states have better healthcare systems than others, and it may make sense to relocate in order to take advantage of this. Each state has its own specific Medicaid network and program, and you may need to research these differences before your move. 

You can also target specific states for other benefits, including homestead exemptions and lower tax rates. An elder law attorney may be able to help you choose the most optimal state based on your unique retirement needs. Finally, it is worth noting that not every state offers managed care plans. If you live in a state that does not offer managed care plans, you might need to relocate before you even consider this option. 

Dual Eligibility and the Danger of “Fragmented Care”

If you are eligible for both Medicaid and Medicare, it might be more challenging for you to navigate this process compared to others. There is a real danger of receiving “fragmented care” due to the lack of integration between these two programs. However, various states and insurance providers are attempting to address these issues for dual-eligible seniors.

You might be able to find an “integrated care plan” that serves only dual-eligible people in your community. Often, these plans cater to people in nursing homes. Because these organizations focus on dual-eligible individuals, they can integrate and coordinate their treatment with greater efficiency. Speak with your elder care lawyer to learn more about integrated care plans. 

Contact The Elderly Care Law Firm Today

Medicaid planning can be challenging if you are working alone. You may feel intense pressure to provide your loved one with effective healthcare services, and it may feel like this task has become a full-time job. Fortunately, you can delegate many aspects of Medicaid planning to an experienced elder law attorney. During your first consultation with one of these legal professionals, you can discuss how your specific state handles managed care. You might also discuss your senior’s unique challenges and priorities. From there, you can ensure your loved one receives the best health care possible. To get started, consider a consultation with The Elderly Care Law Firm today. 

The Impact of Medicaid Expansion: What States Need to Consider

The Impact of Medicaid Expansion: What States Need to Consider

One of the most confusing aspects of Medicaid is its varied nature. Depending on your state of residence, you might have to approach Medicaid with all kinds of different considerations. One of the most controversial and complex aspects of this is “Medicaid expansion.” While this might be a difficult concept to understand, the most important thing to remember is simple: Some states have expanded Medicaid, while others have not. The impact of this could affect seniors and low-income individuals in various ways. Read on to learn more. 

What is Medicaid Expansion, Anyway?

To understand Medicaid expansion, you first have to understand the “eligibility requirements” for this federal program. Different States may determine eligibility in different ways. Some consider multiple factors, including income, the number of people in your family, your disability status, and others. Other states take a simpler approach, and they only consider your income. 

The states that only consider your income level when determining eligibility are said to have “expanded Medicaid coverage.” By enforcing fewer eligibility requirements, more people qualify for Medicaid. In other words, Medicaid is expanded to include more people. 

If your state has expanded Medicaid coverage, you only need to consider one metric: The federal poverty level. As long as your household income is below 138% of this number, you automatically qualify for Medicaid with no further steps required. 

What is the Impact of Medicaid Expansion?

According to the Center on Budget and Policy Priorities, expanding Medicaid has had various effects. Statistics show that when states expand Medicaid, adults are more likely to seek insurance coverage. States also see a rise in mental health outcomes and a reduction in opioid overdose deaths. Some studies indicate a reduction in overall depression rates for states that expand Medicaid. Some say that hospitals have become more financially sound in States that have expanded Medicaid. 

That being said, Medicaid expansion has its fair share of critics. One study found that in states with expanded Medicaid, low-income women had fewer live births. Other studies suggest that expanded Medicaid may be correlated with poor infant and maternal health. 

Some say that Medicaid expansion has forced some Americans off their private insurance policies. These critics claim that if Medicaid expansion spreads to other states, some may have no choice but to go on welfare. They also note that welfare pays less than Medicaid. There is some indication that States that expand Medicaid later could face increased negative effects. 

In 2022, Forbes pointed out that providers may be less willing to accept new Medicaid patients compared to privately insured patients. In some states, wait times for Medicaid patients are longer. Forbes also points to a study that found Medicaid patients were 50% more likely to die from throat cancer compared to privately insured patients. 

How Does Florida Approach Medicaid Expansion?

Florida is one of the many states that has not expanded Medicaid. This is a hot-button issue for many residents, especially those who want to benefit from increased eligibility seen in other states. Others are wary about the potential negative effects of expansion – particularly residents with private insurance. 

So far, Governor DeSantis has been less than enthusiastic about Medicaid expansion. However, he has justified this stance on relatively few occasions. The cost could be considerable. Florida is famous for its high population of seniors, and Medicaid expansion could affect the Sunshine State in ways not seen in other jurisdictions. 

The Paragon Health Institute argues that 30% of Florida residents would be on Medicaid, stretching an overwhelmed healthcare system. Taxpayers would reportedly have to pay a $2 billion bill for Medicaid expansion over the following decade, and this may cause the State to raise its taxes or cut other programs in order to compensate. 

That being said, many argue that voters in Florida should at least get a chance to decide on Medicaid expansion. There is a growing legal battle to put Medicaid expansion on the ballot, and this could happen sooner than many realize. If Medicaid expansion goes on the ballot, there is a high chance of it being approved in Florida. In every other state, Medicaid expansion has been greenlit after reaching the ballot. People tend to vote for Medicaid expansion if they get a chance. 

Currently, seniors may qualify for Medicaid in Florida if their income is below approximately $3,000 per month. They must also have assets below $2,000, and they must need nursing home services. 

Can a Medicaid Lawyer Help?

If you are living in Florida or another state that has yet to expand Medicaid, legal assistance may help you qualify. Even if you do not quite meet the requirements for Medicaid, you might be able to adjust your financial affairs slightly and re-apply. 

The best strategy depends on your unique circumstances. In some situations, the most appropriate course of action might be to take advantage of the Florida Medicaid home exemption. In other situations, you might want to explore strategies involving your spouse. 

It may be easier to qualify for Medicaid than you realize. Alternatively, there may be other sources of financial support to explore. For example, you might pursue compensation for medical treatments under VA benefits if you are a veteran. Lawyers are familiar with these various programs, and they can help you pursue fair compensation based on your unique circumstances. 

Contact The Elderly Care Law Firm Today

If you are ready to have a more detailed discussion about Medicaid expansion, why not schedule a consultation with The Elderly Care Law Firm? Our experienced Medicaid attorneys can help you assess your next steps, depending on your state’s approach to Medicaid expansion. If there is one thing you should take away from this article, it is that the best Medicaid strategy in Florida depends entirely on your unique circumstances. Reach out today to discuss these circumstances in more detail – and get started with an action plan. 

Navigating Medicaid Managed Care: Tips for Beneficiaries

Understanding Medicaid Eligibility: A Comprehensive Guide for Individuals and Families

If you are serious about applying for Medicaid, one of your first steps should be to determine your eligibility. Only certain people are eligible for Medicaid, and these requirements can be quite complex. Fortunately, you may be able to make a few adjustments to become eligible. A Medicaid lawyer can guide you through these steps, helping you achieve financial stability and reliable healthcare throughout the rest of your life. A lawyer can also help you determine whether you qualify for Medicaid based on your unique circumstances. The best way to discuss these circumstances is during a consultation. 

Medicaid Eligibility Differs by State

The first thing you need to know about Medicaid is that eligibility requirements may vary by state. Although some of the requirements are universal, others vary depending on where you live. You may need to discuss your State’s unique requirements alongside your Medicaid lawyer for best results. 

One of the most important factors to consider is whether your state has expanded Medicaid coverage. It may be easier to qualify if your State has expanded Medicaid. If you live in one of these States, you can qualify based on your income alone. As long as your income is below 138% of the “federal poverty level,” you automatically qualify with no other requirements to consider. In 2024, the federal poverty level for a single individual was about $15,000. This poverty level increases by about $5,000 for each additional person in the family. For example, a family of four is associated with a poverty level of $30,000. 

Speak with your lawyer to learn more about the federal poverty income level. It changes from year to year, and calculations can be deceptively complex. Remember, you do not necessarily need to be below the federal poverty level – you only need to be within 138% of the number. 

Basic Medicaid Eligibility Requirements

There are a few other basic, universal requirements to consider when it comes to Medicaid in the United States. Generally speaking, only US citizens are eligible to receive Medicaid. You must also be a legal resident of the State in which you file your application. This second requirement is much easier to meet than citizenship, as you only need to live in the State for six months to become a resident. Some “qualified non-citizens” may also qualify for Medicaid, such as lawful permanent residents. 

Eligibility Requirements That Most States Enforce

Although requirements vary depending on your state, you probably will not qualify if you are under 65 with more than $2,000 in cash. If you are over the age of 65, you may qualify based on more complex requirements. All States have strict rules against some of the most popular qualification strategies. Medicaid officials pay especially close attention to strategies involving asset transfers and gifts. 

California Medicaid Eligibility Requirements

California’s version of Medicaid is called “Medi-Cal.” California is one of the many States that have expanded Medicaid, allowing you to qualify based on your income alone. California also offers Medicaid to various other individuals, including those who are over the age of 65. In addition, people who are blind or disabled may qualify regardless of their age. Pregnant individuals may also qualify, and some youths under the age of 21 could be eligible. If you are a refugee, you might also receive Medicaid in California. Certain cancer patients could qualify as well. 

Texas Medicaid Eligibility Requirements

In Texas, you must have a low income or “very low income” to qualify for Medicaid. You must also fall into one of the following categories:

  • You’re pregnant
  • You’re caring for a child
  • You’re blind
  • You’re disabled or caring for someone who is disabled
  • You’re over the age of 65

In other words, Texas is one of the states that has not expanded Medicaid eligibility. That being said, Texas defines “low-income” in relatively generous terms – as anyone with an income under about $30,000 per year generally qualifies. 

Florida Medicaid Eligibility Requirements

Florida’s Medicaid eligibility requirements are very similar to those of Texas. The Sunshine State has not expanded eligibility, which means you cannot qualify on the basis of income alone. You must be characterized as “low-income” while also falling into one of the following categories:

  • Pregnant
  • Blind 
  • Caring for a child
  • Caring for a disabled person
  • Disabled
  • 65 or older

With that said, the income requirements for Florida are considerably more strict compared to Texas. A single individual can only qualify for Medicaid if their annual income is less than about $20,000 per year. 

New York Medicaid Eligibility Requirements

Like California, New York expanded Medicaid eligibility requirements. This means you can qualify based on your income alone – as long as it falls below the 138% threshold of the federal income poverty level. Aside from this requirement, you can also qualify based on pregnancy, disability, blindness, parenthood, or age (65 and older). 

New York also offers Medicaid based on immigration status. This makes New York one of the few states in which non-citizens and permanent residents can get access to Medicaid. If you are an undocumented migrant living in New York, you might want to speak with a Medicaid lawyer to learn more about this opportunity. 

Strategies for Becoming Eligible for Medicaid

There are various strategies that can help you become eligible for Medicaid. These strategies may depend on the unique requirements of your home state. They could include gifting, transfers, trusts, and homestead exemptions. Speak with your lawyer to learn more about your options if you do not yet qualify for Medicaid. 

Find an Experienced Medicaid Lawyer

Contact The Elderly Care Law Firm if you would like to learn more about Medicaid eligibility. With our help, you can review these requirements in more detail and determine whether you qualify. From there, you can explore various steps and strategies to help you qualify. Even if you are not currently eligible to pursue Medicaid, it may be easier than you think to meet the necessary requirements. To discuss your next steps in more detail, feel free to book a consultation today with our experienced Medicaid lawyers.

Navigating Title XIX: Understanding Medicaid Benefits for Seniors

Although you might not have considered federal programs at a younger age, these benefits may suddenly seem crucial. Seniors encounter many unique health issues, and some of these challenges can appear without warning. Planning for senior healthcare needs with preventative strategies is also a smart move – even if you are not currently dealing with any major medical issues. As a general rule, it is always best to seek healthcare benefits before you actually need them. If you plan for federal benefits after encountering a major diagnosis, it may already be too late. One of the most obvious options for seniors in the United States is Medicaid. What exactly is Title XIX? How can Medicaid help you, and what is the best way to navigate this complex program?

What is Title XIX?

Title XIX falls under the Social Security Act. Although many assume that Medicaid is somewhat new, it has been around for more than half a century. Originally signed into law by President Lyndon Johnson, Title XIX implemented a joint program between the federal government and individual states. The purpose of this program is to provide free healthcare to those who need it most. In general, Medicaid is supposed to be reserved for the following individuals:

  • Low-income people
  • Blind people
  • Disabled people

Although this is a federal program, individual states can control how it is implemented to some degree. As a result, seniors should consider the requirements and features of Medicaid based on their specific state. According to the Centers for Disease Control and Prevention (CDC), these state-by-state differences can vary “considerably.” 

Initially, Medicaid only provided basic levels of insurance to those who could not afford health coverage. Over the years, however, Title XIX has expanded considerably – with more Americans becoming eligible through the decades. Some of these changes have been controversial. For example, the Affordable Care Act expanded eligibility to a considerable degree – covering numerous seniors even if they were above the federal poverty level. Not all states have expanded Medicaid. 

What Does Medicaid Cover?

In theory, Medicaid should provide everything you need for your healthcare needs. However, there are some notable gaps in coverage to consider. These include private nursing, bandages, adult diapers, and other disposable items. Again, Medicaid may vary from state to state. However, Medicaid always provides more coverage compared to Medicare, especially when it comes to nursing home expenses. 

Eligible Medicaid expenses fall into four categories:

  • Part A: Covers all costs related to hospital visits. This includes not only emergency room care, but also emergency transport. 
  • Part B: Covers a range of testing services, such as laboratory services and X-rays. Part B also covers certain medical equipment and outpatient treatment. 
  • Part C: Represents the Medicare Advantage Plan, which is provided by private companies. 
  • Part D: Solely covers prescription drugs. 

If you are already enrolled in Medicare, you could receive additional financial assistance from Medicaid. 

Am I Eligible for Medicaid?

You need to consider a few factors when determining Medicaid eligibility. First, you need to consider your Modified Adjusted Gross Income or “MAGI.” This is essentially your taxable income. If your eligibility is based on blindness, disability, or age, you may not need to worry about MAGI. Remember, eligibility also depends on your specific state. Some states use more strict eligibility requirements, while others are more generous. 

Aside from your income, you should also consider a few other factors. First, you must be a resident of the state in which you’re applying. In other words, you must reside in the state for a certain period of time before applying. Secondly, Medicaid is mostly reserved for US citizens. However, some non-citizens qualify – such as lawful permanent residents. 

Medicaid Across the Nation’s Four Most Important States

Florida, Texas, California, and New York have the highest populations in the country. These states all handle Medicaid in slightly different ways, particularly when it comes to “expanded eligibility.” Ten states, including Florida and Texas, have not expanded eligibility under the Affordable Care Act. The differences between individual states highlight the need for personalized Medicaid planning. An online article can only provide broad information and not specific eligibility information based on your state of residence. 

Strategies for Getting Approved for Medicaid

Because Medicaid is reserved for the financially needy, some applicants choose to strategically restructure their assets and wealth before applying. In many cases, this causes individuals to qualify for Medicaid despite their high wealth. 

One option is a Qualified Income Trust, also known as a “QIT.” This option moves your wealth out of your direct control, establishing a separate legal entity. With no direct ties to your own wealth, you may subsequently qualify for Medicaid. 

Another option is a Pooled Income Trust, which holds surplus income to ensure Medicaid qualification. However, only disabled individuals may establish this type of trust. 

Asset Protection Trusts are also helpful, as they prevent creditors from seizing your assets. These trusts are also known as “Medicaid Trusts.” 

Another popular strategy is a spousal transfer, and it involves one spouse moving assets to the other. With no assets on paper, the spouse who transferred the funds suddenly becomes eligible for Medicaid. Spouses may even legally refuse to support their partners in some states, and this can also lead to eligibility. 

Medicaid strategies are highly situational, and an elder law attorney can help you choose the most appropriate option based on your unique circumstances. 

Find an Experienced Elder Law Attorney Today

If you have been searching for a legal professional who can help with Medicaid, look no further than The Elderly Care Law Firm. As the name suggests, this law firm is all about assisting American seniors with elder law needs. Medicaid is just one example of a federal program that could be beneficial, and there are many others worth discussing. The best way to begin this discussion is by booking a consultation with us today. While internet research is a positive first step, it cannot provide you with personalized advice. Reach out now to speak with a real elder law attorney. 

Preservation of Medicaid

Preservation of Medicaid

Navigating the Crossroads of Windfalls and Medicaid Preservation

When unexpected financial gains come your way, such as inheritances, property sales, or legal settlements, it can seem like a blessing. However, these windfalls can also pose a challenge if they push you over Medicaid’s asset limits, potentially disqualifying you from receiving essential healthcare benefits.

This blog post explains the potential consequences of losing Medicaid eligibility, the legal complexities involved, and strategies to protect your benefits. Additionally, we’ll introduce Elderly Care Law Firm, a team of experienced and compassionate attorneys who can help you navigate this challenging legal landscape.

Pain Points of Losing Medicaid Eligibility

Losing Medicaid eligibility due to windfalls can have significant consequences for individuals and their families:

  • Disruption of Healthcare Services:  Medicaid helps pay for essential medical services, like doctor visits, hospital stays, and prescription drugs. If you lose Medicaid, you might not have access to these important treatments, which could hurt your health.
  • Financial Burden: Medicaid helps cover the high costs of healthcare, reducing the financial burden for individuals and families. Without Medicaid, the cost of medical care can become very expensive, leading to financial problems.
  • Emotional Stress and Anxiety: Losing Medicaid can cause a lot of uncertainty about the future of healthcare and financial stability, which can lead to stress, anxiety, and worry for individuals and families.

Navigating Legal Complexities

Protecting Medicaid benefits during windfalls requires more than just managing finances; it demands a thorough understanding of the legal complexities involved. Asset limits, spend-down strategies, and estate planning are just a few of the legal considerations families must be informed of to protect their loved ones’ eligibility.

  • Asset Limits: Medicaid has rules about how much money and property you can own and still get benefits. Windfalls can easily put you over these limits, which means you might lose Medicaid. It’s important to understand these limits and make a plan for managing your money.
  • Spend-Down Strategies: You can use windfalls to pay for certain things that Medicaid helps with, like medical bills or home improvements. This can lower the amount of money you have that counts towards the Medicaid limit and help you keep your benefits.
  • Estate Planning: Checking and updating your estate planning papers can make sure they work with your goal of keeping Medicaid. It can also help protect your money for your family.

The Expertise of Eldery Care Law Firm

If you’re facing these challenges, Elderly Care Law Firm can help. Elderly Care Law is a team of experienced and caring lawyers who specialize in protecting Medicaid benefits. They understand the complex rules of Medicaid and can develop a personalized plan to keep your benefits safe.

  • Comprehensive Legal Guidance: ECL’s attorneys provide comprehensive legal guidance, explaining complex legal concepts in a clear and understandable manner, ensuring families are fully informed throughout the process.
  • Tailored Strategies: ECL develops customized strategies based on each family’s unique circumstances, taking into account asset levels, income sources, and healthcare needs.
  • Compassionate Approach: ECL’s attorneys prioritize their clients’ well-being, providing empathetic support and advocating for their best interests.

If you have any questions about Medicaid Preservation, please contact Elderly Care Law Firm today for a free consultation. | www.elderlycarelawfirm.com/   | o: (305) 783-3013 f: (305) 836-3315 o: (954) 367-9457

Navigating Medicaid Managed Care: Tips for Beneficiaries

Navigating the System: Answering the Top Five Questions on Medicare

Although Medicare was created to make healthcare easier for those in need, the system itself may not be easy to navigate. If you are encountering the Medicare program for the first time, you might have all kinds of questions about eligibility, benefits, retirement, and much more. Fortunately, a little internet research goes a long way. By answering five of the most common Medicare questions, we can provide you with plenty of insights. Using these insights, you can make a more informed decision about your Medicare journey. 

  1. Who is Eligible for Medicare?

One of the most obvious questions about Medicare involves eligibility. Determining whether you are eligible for Medicare should be your first step in this process, as there is no point in pursuing this further if you will simply be rejected. So how do you know whether you are eligible for Medicare?

According to the US Department of Health and Human Services, Medicare is primarily geared toward people who are 65 or older. In other words, this problem was designed specifically for retirees. That said, there are a few groups who may become eligible for Medicare even before the age of 65. These groups include:

  • Those with disabilities
  • Those with End-Stage Renal Disease
  • Those with ALS 

In addition, there are a few other requirements to consider if you are planning to apply for Medicare. First of all, you need to be a US citizen to qualify for this program. Alternatively, you can qualify if you are a permanent legal resident, but only if you have lived in the country for at least five years. 

Finally, you may need some kind of work history in the United States in order to qualify for this program. Those who have been receiving Social Security often qualify for Medicare, and Railroad Retirement recipients fall into the same general category. Alternatively, you may qualify for Medicare if you are a government employee or retired government worker. These government workers may qualify even if they have not paid into Social Security – as long as they have paid Medicare payroll taxes during their career. In addition, you may qualify for Medicare if your spouse is a government worker who falls into this category. 

  1. What Kind of Benefits Does Medicare Provide?

The coverage and benefits provided by Medicare may vary depending on your choices and your unique circumstances. Most Medicare recipients are faced with one major choice, and this is a choice between “Original Medicare” and a “Medicare Advantage Plan.” Medicare Advantage is also known commonly as “Part C.” 

Original Medicare consists of Part A and Part B. This plan is completely managed by the federal government, and it covers a wide range of healthcare providers. The government pays a portion of the total cost of these medical services. 

Part A focuses on hospital care, and it may include nursing homes. On the other hand, Part B covers regular visits to the doctor for non-emergency reasons. In addition, Part B may cover various supplies and additional services, as long as they are “medically necessary.” Finally, Part B includes certain types of preventative care, ambulance services, some mental health treatment, and certain prescription drugs. 

While Part A and B are covered by the federal government, Part C is entirely handled by private insurance companies. Also known as Medicare Advantage, this program provides all of the benefits listed under Parts A and B while also offering additional coverage for prescription drugs. A number of additional healthcare services may be bundled together with Advantage plans, including vision, hearing, and dental care. 

  1. When Should I Claim Medicare?

Generally speaking, it is a good idea to claim Medicare as soon as you become eligible. There are certain penalties for signing up late, and you need to be aware of the specific enrollment periods that apply to your situation. The most obvious option is to sign up for Medicare as soon as you turn 65. Whatever the case may be, you can feel relatively confident about being accepted as long as you are 65 years of age. Another option is to leave your active group health plan and transition to Medicare. 

In fact, you can start the enrollment process three months before you turn 65. This is known as the Initial Enrollment Process or “IEP.” In addition, you can apply three months after you turn 65 – which gives you a total of 6 months to file your application during this window. As previously noted, there are certain situations in which people may become eligible for Medicare even before they turn 65 – so it’s probably a good idea to begin the conversation with an elder law attorney as soon as possible. 

  1. What is the Difference Between Medicare and Medicaid?

People often get Medicare and Medicaid confused. While Medicare is essentially just a state-funded health insurance plan, Medicaid is basically a type of welfare. Medicaid has more strict eligibility requirements, as this program is specifically geared toward people with limited resources. In addition, Medicaid may provide coverage for things that Medicare may not cover, such as nursing home care. Medicaid may also cover younger adults or even children, while Medicare targets elderly individuals. 

  1. What is Part D of Medicare?

Part D of Medicare refers specifically to prescription drugs. This is an option upgrade for your standard Medicare plan, and it is included in Advantage plans. That being said, some types of prescription drugs are covered by Plan A and D. 

Who Can Help With My Medicare Journey?

While internet research is a positive first step, it can only get you so far. Aside from these five common questions, there are many other confusing aspects of Medicare that can be difficult to wrap your mind around. In order to approach this process with a degree of confidence and efficiency, it may be worth booking a consultation with the Elderly Care Law Firm. During this initial meeting, you can ask any additional questions about the Medicare process. Reach out today to get started.