Medicare and Medicaid
Medicare and Medicaid are subsidized government programs that help people access medical care that would otherwise be unaffordable – and there is where the similarity ends. Although the two programs are often confused, they are very different, with different administrations, missions, population and scope.
Medicare
Medicare is the federal medical insurance program for those over 65 years of age, and for those who have been diagnosed with certain medical conditions, such as ALS or end stage renal disease, requiring dialysis. There are four basic parts to Medicare:
Part A, or hospital insurance, covers the bulk of basic hospitalization charges.
Part B covers physicians’ charges, lab tests, and durable medical equipment.
Part C, or Medicare Advantage plans, is a program that allows you to access your Medicare benefits via a private managed care company, approved by Medicare authorities.
Part D covers most prescription drug coverages.
Part A is free, and you are automatically enrolled when you become eligible. You are also automatically enrolled in Part B, though there is a premium for this plan. Part C and Part D you must specifically opt in to in order to receive benefits under these programs. There are also premiums you must pay for this coverage.
Medicaid
Medicaid is the federally-subsidized, state-administered program that provides medical insurance for the poor, the indigent, and for children of low-income families. In Illinois, the Medicaid program is administered by the Department of Health Care and Family Services, or HCF. For seniors to be eligible for Medicaid in Illinois, you must first document that their incomes are below a certain level, and you must spend your personal assets down to less than $2,000. Illinois, like many states, does exempt certain kinds of property from consideration, such as a limited amount of home equity. However, once you have passed on, the State of Illinois may recoup any money it spent on providing Medicaid benefits to you from your estate.
To apply for Medicaid, visit the Department of Health Care and Family Service’s web site at www.hfs.illinois.gov.
What is a Medicare Medigap Plan?
Medigap insurance, also known as Medicare supplement plans, are special health insurance plans designed to pick up where Medicare leaves off. Medicare doesn’t cover everything. In fact, there are substantial gaps in Medicare coverage that can be potentially devastating to Illinois Medicaid enrollees who do not have any kind of coverage.
What are the gaps?
Illinois Medicare enrollees are often surprised when they get a bill from their hospital or other health care providers after a hospital stay. Medicare only provides partial coverage, though. The Illinois Medicare enrollee may still have to pay significant deductibles. Specifically, Medicare Part A still leaves you with a $1,132 bill for a hospital stay of between 1 and 60 days. After that, you will have to pay $283 per day to the hospital for days 61-90, and $566 per day for days 91 through 150.
Medicare Part B only covers 80 percent of your physicians and lab fees, at best. Illinois Medicaid enrollees must pick up the rest.
Medigap Insurance
Medicare Medigap insurance helps cover the items that Medicare doesn’t cover. There are a variety of approved Illinois Medicare supplement plans available. You can choose plans that provide very basic coverage or more extensive plans that provide special benefits to frequent overseas travelers, or include coverage for prescription drugs, for instance.
Purchase Illinois Medicare Supplement Insurance
To get a quotation for Illinois Medicare Supplement insurance, simply use our online quoting engine at www.abchealthplans.com. It’s free!