MEDICARE

Medicare is a federal health insurance program available to people 65 years of age or older, some persons with disabilities under the age of 65, and people with end-stage renal disease. There are four parts to Medicare–Part A, Part B, Part C, and Part D.

Part A is referred to as hospital insurance and generally helps pay for inpatient hospital care, skilled nursing facility care, hospice care, and home health care.

Part B is referred to as medical insurance and helps to pay for medically necessary services and preventative services, such as ambulance services, durable medical equipment, and mental health. Enrollment in Part A is available to most senior citizens at no charge. Part B, however, must be purchased by paying a monthly premium. It should be noted that under certain circumstances some individuals may have to pay more than this premium amount, and in other cases, the cost may be covered for certain recipients with Medicaid eligibility.

Individuals may choose to receive their health care coverage through original Medicare or Medicare Advantage, also known as Part C. Medicare Advantage plans (like an HMO or PPO) are offered by private companies that provide all Part A and Part B benefits.

Some plans also offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs.

Part D prescription drug coverage may be purchased with original Medicare or through a Medicare Advantage Plan. Most Medicare Advantage plans include Part D coverage. Part D is voluntary, and there are a variety of options available for Part D with different levels of coverage and costs.

Medigap policies, otherwise known as Medicare supplement insurance policies, are available for purchase from private insurance companies and can help pay for costs not covered by original Medicare, like copayments, coinsurance, and deductibles.

Medicare supplement insurance may also provide coverage for services that the original Medicare plan does not. You do not need to purchase a Medigap policy if you are enrolled in Medicare Advantage.

Michigan Medigap policies are sold in standardized plans known as plans A, B, C, D, F, G, K, L, M, and N, and each has a different set of benefits. Plan A covers only the basic core benefits, while Plans B through N cover basic core benefits and additional benefits.

For further information about Medicare and Medigap policies or to request and receive a variety of Medicare and related booklets, call 1-800-MEDICARE (1-800-633-4227), TTY/TDD 1-877-486-2048 (for the hearing and speech impaired), or access the Medicare website at medicare.gov. Individuals can also call the Michigan Medicare/Medicaid Assistance Program at 800-803-7174 for help.

MEDICAID

Medicaid is a health care coverage program jointly funded by states and the federal government. The program helps to ensure that essential health care services are made available to those who otherwise would not have financial resources to purchase them. Eligibility for Medicaid depends on your family size (individuals may qualify too), income, and assets. Medicaid can help pay for Medicare premiums.

Medicaid provides some medical services, support services, and long-term care services that are not covered by Medicare, such as the MI Choice Waiver Program.

The MI Choice Waiver Program is a Michigan Medicaid program that provides long-term care services and supports in your home or another residential setting.

Applicants are eligible for MI Choice if they meet income and asset criteria and other medical and functional criteria. Participants receive basic Medicaid services as well as one or more services unique to the program, such as community transition services, community living supports, nursing services, respite services, or adult day care, among others.

If you have questions or would like more information about the Medicaid program, contact the Michigan Department of Health and Human Services at 1-800-642-3195, TTY/TDD 1-866-501-5656 (for the hearing and speech impaired), or the Michigan Medicare/Medicaid Assistance Program at 1-800-803-7174.

There is also information about Medicaid programs online at michigan.gov/mdhhs/assistance-programs.