Turning 65 soon? Transitioning to dual Medicare and Medicaid coverage and getting help with costs

If you’re enrolled in Medicaid and will soon have Medicare eligibility, it’s not too soon to start planning ahead. Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

Once you have Medicare and Medicaid coverage, Medicare will cover your Part D prescription drugs and you’ll automatically qualify to get Extra Help paying for your drug costs. If you have limited income and resources, you may also qualify for help paying for your Medicare Part B premium and other Medicare costs, like deductibles and coinsurance. Medicare and your state Medicaid program work together to provide you with this help, called the Medicare Savings Programs.

The 4 Medicare Savings Programs (MSPs)

If you have income from working, you may qualify for these 4 MSPs, even if your income is higher than the income limits listed below. Each program has a different income and resource eligibility limit. Even if you don’t qualify for Medicaid, you may qualify for one of these programs to help you cover your Medicare costs.

How do I apply for Medicare Savings Programs?

If you answer yes to these 3 questions, call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state:

  1. Do you have, or are you eligible for, Part A?
  2. Is your monthly income for 2015 at, or below, $1,333 (single) or $1,790 (married or living together)?
  3. Do you have limited resources, less than $7,160 (single) or $10,750 (married or living together

It’s important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.

What items are included in the Medicare Savings Program resource limits?

Countable resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds

Countable resources don’t include:

  • Your home
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items

How can I keep my costs down?

Protect yourself from pneumonia and other infections

Did you know that 900,000 Americans get pneumonia every year? Pneumonia is a lung infection caused by pneumococcal disease, which can also cause blood infections and meningitis. The bacteria that causes pneumococcal disease is spread by direct person-to-person contact.

Medicare can help protect you from pneumococcal infections. The best way to prevent these infections is by getting the pneumococcal shot. Medicare Part B covers the shot and a second one 11 months after you got the first shot for anyone with Part B.

You may be at a higher risk for these infections if you:

  • Are 65 or older
  • Have a chronic illness (like asthma, diabetes, or lung, heart, liver, or kidney disease)
  • Have a condition that weakens your immune system (like HIV, AIDS, or cancer)
  • Live in a nursing home or other long-term care facility
  • Have cochlear implants or cerebrospinal fluid (CSF) leaks
  • Smoke tobacco

You can learn more about Medicare-covered vaccines by watching our video. Take an easy step towards prevention, and get your pneumococcal shot today.

Medicare protects you on World Hepatitis Day and every day

Hepatitis – “inflammation of the liver” – is often caused by viruses which affect millions of people worldwide and kill close to 1.4 million people every year.

Hepatitis is contagious. For example, the Hepatitis B virus spreads through contact with the blood or other body fluids of an infected person. People can also get infected by coming in contact with a contaminated object, where the virus can live for up to 7 days. Hepatitis B can range from being a mild illness, lasting a few weeks (acute), to a serious long-term illness (chronic) that can lead to liver disease or liver cancer.

Fortunately, Medicare can help keep you protected from the most common types of viral hepatitis strains—Hepatitis A, Hepatitis B and Hepatitis C.

Generally, Medicare Part D (prescription drug coverage) covers Hepatitis A shots when medically necessary.

Medicare Part B (Medical Insurance) covers Hepatitis B shots, which usually are given as a series of 3 shots over a 6-month period (you need all 3 shots for complete protection).

Medicare covers a one-time Hepatitis C screening test if your primary care doctor or practitioner orders it and you meet one of these conditions:

  • You’re at high risk because you have a current or past history of illicit injection drug use
  • You had a blood transfusion before 1992, or
  • You were born between 1945 and 1965

July 28 is World Hepatitis Day. Worldwide 400 million people are living with Hepatitis B or Hepatitis C. Find out how you can prevent hepatitis and save 4,000 lives a day by visiting the World Health Alliance’s World Hepatitis Day web page.

Medicare and Medicaid: keeping Americans healthy for 50 years

Did you know Medicare and Medicaid turn 50 this week? The landscape of health care in America changed forever on July 30, 1965, when President Lyndon B. Johnson signed the landmark amendment to the Social Security Act, giving life to the Medicare and Medicaid programs. Medicare and Medicaid save lives. They help people live longer and provide the peace of mind that comes with affordable health care that’s there when you need it.

It’s easy to forget that before 1966, roughly half of all seniors were uninsured and many disabled people, families with children, pregnant women and low-income working Americans were unable to afford the medical care they needed to stay healthy and productive.

Today, Medicare and Medicaid cover nearly 1 out of every 3 Americans—that’s well over 100 million people. It’s highly likely that you, someone in your family or someone you know has Medicare, Medicaid or both. Celebrating the 50th anniversary of these lifesaving programs lets us reflect on how they transformed the delivery of health care in the United States.

More than 55 million Americans depend on Medicare to cover hospital stays, lab tests and critical supplies like wheelchairs, as well as prescription drugs. Medicare also covers 23 types of preventive services, including flu shots and diabetes screenings. Some of these services are free, and for others you only have a small copayment or pay the deductible.Medicaid provides comprehensive coverage to more than 70 million eligible children, pregnant women, low-income adults and people living with disabilities. It covers essential services like annual check-ups, care for new and expecting mothers, and dental care for kids from low-income families.

How has Medicare or Medicaid (or both) helped your life or the life of someone you care about? Whether you’ve just enrolled or have been covered for decades, we’d love to hear from you. You can share your Medicare or Medicaid story through our Medicare.gov website, or connect with us on Twitter or our newly-launched Facebook page.

Choosing a home health agency just got easier

Are you the kind of shopper who reads reviews or looks at ratings before you make a purchase? Wouldn’t it be helpful to have the same kind of ratings when choosing a home health agency?

Choosing a home health service can be overwhelming. Agencies differ in the safety and quality of care they provide. That’s why we’ve made it easier to use the information on our Home Health Compare site by adding quality of patient care star ratings.

Compare websites are a valuable source of information about the quality of health care providers and facilities. The quality of patient care star ratings we’ve just added to the Home Health Compare website summarize each agency’s performance across 9 quality measures, including things like:

Agencies get a rating from 1 to 5 stars, with 1 as the lowest score and 5 as the highest. Agencies get a higher star rating when they follow recommended care practices for more patients, and when more of their patients show improvement.

Sharing patients’ experience of care through star ratings is just one example of how we’re committed to helping you make health care decisions based upon available information. We just made it easier to use the information on our Hospital Compare site by adding star ratings for patients’ experience of care. Our Nursing Home Compare site already uses star ratings to help consumers compare nursing homes and choose one with quality in mind. Physician Compare has started to include star ratings in certain situations for physician large group practices, and we added star ratings to our Dialysis Facility Compare site to help to make data on dialysis centers easier to understand and use.

The methodology for calculating the Quality of Patient Care Star Rating is based on a combination of individual measure rankings and the statistical significance of the difference between the performance of an individual HHA on each measure (risk-adjusted, if an outcome measure) and the performance of all HHAs. An HHA’s quality measure values are compared to national agency medians, and its rating is adjusted to reflect the differences relative to other agencies’ quality measure values. These adjusted ratings are then combined into one overall star rating that summarizes performance across all 9 individual measures. The details of the calculation are included in the methodology report referenced above.

What you need to know first about enrolling in Medicare

A healthy life is a good life. The Medicare benefits you’ve earned ensure that you can receive the care you need, when you need it.

And, when it comes to Medicare benefits, the most important thing to remember is to apply for them at age 65.

On your behalf, advocacy groups asked us to place a greater emphasis on information about enrolling in Medicare at age 65, and specifically, about the potential problems that arise if you don’t.

In the past few months, in conjunction with the White House Conference on Aging, the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration have strengthened many of our communications products to ensure that all people nearing age 65 hear the following message:

Three months before your 65th birthday, you should apply for Medicare benefits. At that time, you’ll be asked to elect if you also want Medicare Part B that helps pay for doctors’ services and many other medical services and supplies that hospital insurance doesn’t cover. If you don’t sign up at age 65, and you then decide to enroll later, you may pay a lifetime late enrollment penalty and you may have a gap in medical insurance coverage. There are exceptions, but play it safe, and ask your Medicare or Social Security representative about your personal situation.

To make this message clear, our two agencies have already:

In the next few months, we will update our website and the Medicare initial enrollment period package; revise more Medicare publications; and add online resources for people who are still working.

Visit Medicare.gov to find out more about enrolling in Medicare. And, remember to apply online for Medicare three months before your 65th birthday!

Take control, take the test for HIV

Did you know that about 1 in 7 of the more than 1 million Americans infected with Human Immunodeficiency Virus (HIV) don’t know they’re carrying the virus?

And, about 1 in 4 people in the U.S. who test positive for HIV are tested too late to get the full advantage of treatment. The good news is that testing is an important first step in getting HIV-infected people the medical care and support they need to improve their health and help them maintain safer behaviors – and Medicare can help.

Medicare covers HIV screening for people with Medicare of any age who ask for the test, pregnant women, and people at increased risk for the infection (such as gay and bisexual men, injection drug users, or people with multiple sexual partners).

HIV is the virus that can lead to Acquired Immunodeficiency Syndrome, or AIDS. There have been many advances in treatment, but early testing and diagnosis play key roles in reducing the spread of the disease, extending life expectancy, and cutting costs of care.

Take control and take the test. Visit Health & Human Services’ Aids.gov website to learn more about National HIV Testing Day, June 27 and watch our video.