medicaid /medicare

[huey duey & luey]

Could someone please explain to me the difference between care and caid as far as receiving services? I understand that it has to do with $, but I don't know how they determine how someone is not entitled to a needed service because they have too much money$. In other insurance carriers I dont think you can be denied because you have too much money. Does this ? even make sense?
Tara

 

[Breezy_Carol]

Medicaid is based on financial need. It is a state run insurance program for people who qualify as low income.

Medicare is Federally run for mostly people over 65 years old. Some people who qualify as disabled can also receive medicare.

Hope this helps.

 

[Dan Murphy]

Medicaid

Medicare

Maybe a help...........

 

[NHAnn]

This is just my basic understanding...

Medicare is insurance for Americans 65 and older. It consists of Part A (hospitalization coverage) which is usually free is you have enough SS credits, and Part B (physician services) for which there is a premium deducted from your SS benefits. There is now a prescription drug benefit avalable through Medicare too. Many retired Americans find is necessary or desirab;e to have private supplemental coverage due to the limitations on what Medicare covers.

Medicaid as I understand it is medical coverage at any age if you are "poor" as defined by the government...no other coverage, maxed out on private insurance or Medicare and no asset/resources for care.

Maybe someone else can fill in more details..........or you can always do a search and try to find a layman's explanation or FAQ or somehing on the official government websites....

 

[PamOKW]

Everyone has explained the difference quite well. The key for you to keep in mind is that these aren't exactly insurane programs like Blue Cross, United Healthcare, etc. They are federally and state run health (some providing insurance) programs. Is there a specific situation that you are trying to figure out?

 

[huey duey & luey]

Originally posted by PamOKW
Is there a specific situation that you are trying to figure out?

My father has medicare, and was just released from the hospital. He has a terminal disease called Shyy-Drager syndrome or Multi Sysytem Atrophy ( it is similiar to Lou Gerig's disease). medicare denied nursing services, Physical therapy and a home health aide. He is in a wheelchair, has a tracheostomy and is catherized. I was trying to figure out why he was denied and was wondering if he would have been denied he is had medicaid(doesnt qualify). I told my mother she should try to appeal. My mother is paying privately for Physical therapy, and will probably end up getting some sort of in home care, but she is his caregiver and at this point he really cant be left alone.
tara

 

[laurie31]

Originally posted by huey duey & luey
I was trying to figure out why he was denied and was wondering if he would have been denied he is had medicaid(doesnt qualify). I told my mother she should try to appeal.

Your father should reapply or appeal. We have medical social workers at our hospital who assist families with needs like this and one of them once told me that EVERYONE is denied the first time

Apparently the government feels if you're *really* in need, you will reapply. She said it's their way of cutting back on fraud. I don't know if this is true in other states, but she would tell families that their first application would be rejected out of hand and not to be discouraged, to just consider it "a practice run" and reapply.

Isn't it awful to have to deal with such things when your family member has a serious illness? Prayers to you and your family. I hope your father is able to get the care he needs, and your mother is able to get some help! Caregivers can become exhausted

Laurie