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What types of medical coverage will I get?
MEDICARE: Medicare is the primary health insurance program for people age 65 or older. However, people younger than age 65 can qualify for Medicare, if you are in one of these categories:
* Blind or disabled (as determined by the Social Security Administration * Permanent kidney failure * Amyotrophic lateral sclerosis (Lou Gehrig’s disease). Medicare can help with the cost of health care, but unfortunately, it does not cover all medical expenses or the cost of most long-term care. Premiums are deducted monthly from your Social Security check. Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period. The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage. During this qualifying period for Medicare, the you may be eligible for health insurance through a former employer, or you may be eligible for Medicaid. MEDICAID Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. If you receive Supplemental Security Income benefits, you are automatically eligible for Medicaid. You may also qualify for Medicaid if you are a citizen of the United States or an "eligible" person, meet the financial eligibility requirements, and are in one of the following categories: *A relative caretaker of a deprived child*. *Pregnant. *Under age 19. *Age 65 or older. *Blind or disabled.
Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services. To apply for Medicaid, you would need to apply through your local county human services office. MEDICAID PURCHASE PLAN The Medicaid Purchase Plan offers people with disabilities who are working or interested in working the opportunity to buy health care coverage through the Medicaid Program. Depending on an individual’s income, a premium payment may be required for this health care coverage. To qualify for the Medicaid Purchase Plan, the following requirements must be met. The participant must: *Be at least 18 years old. *Have individual countable assets of less than $15,000. (Countable assets include savings, life insurance policies, stocks or bonds. A home or one vehicle is not considered a countable asset.) *Be determined to have a disability by the Department of Health and Family Services’ Disability Determination Bureau or Social Security. *Be employed in a paid position or be enrolled in a certified Health and Employment Counseling program. *Have an adjusted family income of less than 250% of the federal poverty level, based on your family size. Contact the county/tribal social or human services department for additional information.
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