Medicare and Medicaid have long been a mystery to many. In fact, it can baffle and confuse even some of the smartest citizens. You might have thought, “I don’t need to worry about this right now.” However, it is never too early to gain a little understanding and awareness that just might help you help an aging loved one or yourself down the road. As the saying goes, “Time flies,” and you will be there sooner than you think. Let’s break it down and learn some of the differences and basics of Medicare and Medicaid to unlock the mystery.

Medicare

Medicare is a health insurance program provided through the federal government. In order to receive Medicare, a person must meet certain requirements. A person must be 65 years old or older or have a severe disability. In order for a disabled person under the age of 65 to be eligible for Medicare, they must have received Social Security Disability Insurance (SSDI) for two years. In order to be eligible a person must have Social Security retirement benefits or Social Security disability benefits. Because Medicare is run and administered by the federal government, it is uniform from state to state. If a person meets Medicare eligibility requirements, they can receive Medicare no matter their income or assets. Costs for Medicare are based on the recipient’s work history. This means that costs are determined by the amount of time a person paid Medicare taxes. These costs like all insurance include premiums, copays, and prescriptions.

Medicare can be confusing because there are four parts. The commercials talk about Parts A, B, C, D. What does it all really mean? Parts A, B, and D can be somewhat simplified. Part A is hospital insurance, Part B is medical insurance, and Part D is prescription drug coverage. Parts A and B are covered in Original Medicare offered by the government. Part C is often called the Medicare Advantage Plan. This is a private health plan. The Medicare Advantage Plan or Medicare Part C plan are required to include the same coverage as Original Medicare but usually also include Part D as well. It is important to do your homework on these plans to find what works best and is most cost effective for you.

Medicaid

Medicaid is a health care assistance program. Its guidelines come from the federal government, but it is administered by each state. Medicaid is for people who cannot afford to pay for their care on their own. It is based on income and assets, and is available to people who belong to one of the eligible groups. The eligible groups are children, people with disabilities, people over age 65, pregnant women, and the parents of eligible children. Seniors who require nursing home care can qualify for Medicaid and only pay a share of their income for the nursing home. Medicaid then pays the rest.

Dual Eligibility

A person can be eligible for both Medicare and Medicaid and can have both. The two programs work together to help the recipient best cover the expenses of health care. For example, Medicare costs include premiums, copays, and deductibles. Full Medicaid benefits can cover the costs of Medicare deductibles and cover the 20% of costs not covered by Medicare. Medicaid can also help with Medicare assistance and may cover costs of premiums for Part A and/or Part B.

Although Medicaid and Medicare can be quite confusing, it is important at a minimum to know the basics. When you or someone you love is eligible or in need of the benefits, there are organizations willing to help and your elder law attorney is also a valuable resource.

If you have any questions about something you have read or would like additional information, please feel free to contact us.

Walking. It is one of the most effective ways to maintain your overall health as you age. It provides a myriad of benefits both physical and mental. Grab a buddy and walk. It can be your spouse, your neighbor, your children, a friend, your dog or any combination of these. If you don’t have a dog consider adopting a middle-aged slightly overweight pooch and both of you walk. Help each other to get more fit. Dogs are wonderful companions and can reduce your stress levels and they are dedicated to wanting to walk! Of course prior to embarking on a new walking program and particularly if you already have health complications talk to your physician first about how best to approach a walking routine. They may have important input or restrictions for you to consider.

Steady walking over time will help you to lose weight which can, in turn, lower your blood pressure, reduce the risk of developing type 2 diabetes, and help your overall circulation. In the time it can lower your risk of cardiovascular disease. Walking helps you to build muscle tone in your legs and even in your abdomen. It is an excellent way to help prevent the loss of muscle mass that occurs with aging. As walking is weight bearing (you being the weight) it can also reduce the risk of bone loss. 

Another benefit to a regular thirty minute walk each day is an increase in balance and stability. It is well documented that falling down as we age can have disastrous consequences. As you walk you engage the hips, stomach and other muscles which keep the walking joints flexible. For anyone experiencing arthritis, it is important to keep moving and walking is a low impact activity that is good for your joints. The more you walk the better it can become for your balance, stability, and flexibility. 

You can also improve the quality of your sleep by walking. Many people find as they age that they have trouble with uninterrupted, restful sleeping patterns. Physical exertion (not exhaustion) is one of the keys to promote a good night sleep. The mental benefits of walking also aide in a balanced nights rest. The simple act of walking allows you to unwind your brain; no cell phones allowed unless for emergency purposes! Being out in the natural world helps your brain to reboot and stay young. It can slow mental decline which is a big factor for positive self esteem and confidence. If at all possible walk in nature rather than on a treadmill at the gym. On inclement weather days a treadmill is fine but the benefits for your mental well being are multiplied when out of doors. Remember to get your walking done in the daylight hours as exertion just prior to sleep does not promote restfulness and it can be dangerous to walk outdoors in the dark.

Aging and the advent of depression is a very real issue facing many seniors. Many are losing relatives and spouses, friends and co-workers. Loneliness can become a problem. Getting to doctors appointments might require someone to drive you. You may be facing money challenges or health insurance coverage problems. There are so many big decisions that come at you in a moment when you would just prefer things to stay the same and be predictable. This can all be overwhelming and can bring about serious depression. Walking is an aerobic activity and aerobic activities release endorphins into your system. Endorphins are the feel happy chemical of your body. The simple act of taking a walk on a daily basis can ward off depression as you age. 

So get yourself a good pair of sturdy shoes with a proper fit and get moving. It is one of the most important things you can do for your well being. Walking is wonderful for people of all ages but particularly seniors. It can help you physically, make you happier and keep you mentally sharp as you live out your retirement years.