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Medicare and Medicaid: Can they go together?

Dear Marci,

If I have Medicare, am I allowed to enroll in Medicaid programs as well?

Loretta

Dear Loretta,

Yes. Medicaid programs can help pay for Medicare’s costs and for services that Medicare doesn’t cover. If you’re eligible for Medicare and have low income, you may qualify for help from certain Medicaid programs in your state. In general, your state will have more than one program that can help people who are eligible for Medicare. Whether you qualify for a Medicaid program will depend on:

SBlt Income from Social Security payments or wages that you earn;

* Assets such as checking and savings accounts, stocks and some property; and

* Whether you need long-term care and meet your state’s “functional eligibility” or “level-of-care” criteria. This includes standards for assessing your need for help with activities of daily living such as toileting, bathing and dressing and your need for nursing care. Each state sets its own standards.

In general, people with Medicare who have low income may qualify for one of the following:

* Medicaid for people who are over 65, blind or have a disability and don’t need long-term care;

* Nursing facility Medicaid; or

* Medicaid Waiver Programs for long-term care in your home or community

To find out what Medicaid programs exist in your state, contact your State Health Insurance Assistance Program at www.shiptalk.org or local Medicaid office.

Dear Marci,

I’m planning to get a hepatitis B shot. Will Medicare cover it?

Gary

Dear Gary,

Your Medicare health coverage (Part B) will cover vaccines to prevent hepatitis B only if you are at medium to high risk for hepatitis B (you have kidney failure, hemophilia or travel to countries with high rates of the disease). In 2010, if you are at medium to high risk, Medicare will cover 80 percent of the cost of your hepatitis B vaccine after you pay your annual Part B deductible.

Dear Marci,

I just received a Medicare Summary Notice in the mail, and I’m not sure what it is. Is it a bill?

Ramesh

Dear Ramesh,

When Original Medicare processes a claim for health care services you received, the claim is detailed in a Medicare Summary Notice. The MSN is a summary of claims for health care services Medicare processed for you during the previous three months. The MSN is not a bill.

MSNs are mailed four times a year and contain information about submitted charges, the amount that Medicare paid and the amount for which you are responsible.

The most important fields on your MSN explain the total amount your doctor or other provider may bill you and non-covered charges, if any.

Try to save your MSNs for about seven years. You might need them in the future to prove that payment was made if a provider sends you a bill, or that services were rendered if you claimed a medical deduction on your taxes. If you have lost your MSN or need a duplicate copy, call 800-MEDICARE. You will be redirected to the Medicare carrier who originally issued the MSN, who can send you a copy.

Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare.