Every time you get paid, you get a small amount for your social security benefits. These payroll deductions are paid for by your federal Medicare health insurance benefits. When you leave the workforce at age 65 or earlier because of a disability, your Medicare coverage begins. It also covers your children under the age of eighteen, if you die before you retire. You will get Medicare, even if you are a millionaire, if you paid in sufficient amounts. It does not depend on your assets or income. Bill Gates will get his coverage.
Medicare coverage is not complete and may be paid. Most retirees buy additional insurance for some services that do not provide the main benefits of Medicare. Medicare covers hospital stays and limited qualified nursing facilities in Part A. Doctors, outpatient care, and medical supplies are covered in Part B. The two biggest gaps in Medicare coverage are long-term care and prescription drugs. You cannot double, and if you get coverage from another source, Medicare has some reimbursement rights.
On some days, I think Congress called our two very different national health programs, Medicare and Medicaid, to confuse us.
Medicaid, on the other hand, is a social welfare program that is not funded through social security. This is due to our general taxation of about half paid by each state and the balance paid by Congress. Each state develops its own program. Medicaid covers much more services than Medicare, and there are no co-payments. Medicaid covers hospitals, doctors, drugs, x-rays and home care.
The key for Medicaid is that you have to be very poor. Your income and resources should be below the threshold set by the federal government, and adjusted every year. You must also be able to prove that you are a US citizen. Foreigners cannot get Medicaid benefits.
While Medicaid will pay for home care for a long time, if your family member meets federal medical requirements, there are certain hooks. Medicaid may approve a salary payment clause for some future income, inheritance, gifts, winnings, and your property. You will also not be eligible if you give anything for five years before you apply. The period of time during which you are not entitled is based on how much you have given. Some transfers to spouses or children with disabilities are exempt from the rules of punishment.
Surprisingly, the Congress showed some caution not to deceive a healthy spouse or disabled children who stay at home in the community. A home, a car and approximately $ 100,000 can be returned to them when the disabled spouse goes to a nursing home. Congress also permits limited asset protection planning and has authorized the use of the “Special Needs Targets” in a law called “OBRA 95”.
All the rules are laid out on 95,000 pages of books called POMS. You can read them all at http://www.ssa.gov. It helps to learn a little about the federal health benefits of your family and the difference between Medicare and Medicaid. The rules in this article are very general, and it is important to have accurate guidance for each case.
