Part II: Medicare and Medicaid Tips for Better Care

Medicare is insurance for people age 65 and over, those with certain chronic disabilities and people with kidney failure. Medicaid is insurance for people with very low incomes and financial resources. People ages 65 and older who have limited income and savings may qualify for both programs.

See the March 2008 issue of Quick Facts for information on what Medicare and Medicaid cover. Below are a few tips to help you get the most out of these programs:

• Home care is available to anyone with a "skilled need" under Medicare Part A. If you have difficulty getting out of the house without assistance, you may qualify for short periods of nursing or physical therapy at home. Some examples of skilled needs are:
• • monitoring blood pressure
  • monitoring symptoms such as shortness of breath and pain
  • care for a wound
  • physical therapy (for weakness or after a fall)
  • education about management of chronic diseases such as diabetes or heart failure
• If you need medical equipment such as a cane or walker, Medicare Part B will help pay, but you must first get a prescription from your doctor. Wheelchairs are generally only covered if they are needed to get around the home.
• Equipment for diabetics, such as glucose monitors and test strips, is covered under Medicare Part B.
• Medicare Part D has multiple plans in every state, each of which have different lists of covered drugs. If your loved one is on many chronic medications, it may be helpful to compare plans or ask your pharmacist for help to figure out which one is most beneficial.
• Medicare Part A generally pays for palliative care services in the hospital, while Medicare Part B covers outpatient visits.
• Some states have innovative Medicaid "waiver" programs that will allow a family member to be a paid caregiver. Check with your state Medicaid office to learn more.
• Medicaid pays for supplies and equipment such as diapers, absorbent pads, special toilet seats and grab bars.
• Many nursing homes only have a certain number of "Medicaid" beds. So if you have some funds to use before qualifying for Medicaid, it is best to find a nursing home you like and pay for a few months out-of-pocket.  That way you’ll be more likely to get a bed in a home you like.

For more information on Medicare and Medicaid visit:

www.medicare.gov

www.cms.hhs.gov/home/medicaid.asp