This question has been closed for answers. Ask a New Question.
Find Care & Housing
Hi Sandra,
Medicare is a Federal program primarily for those aged 65 or older. Someone under 65 may qualify for Medicare by being disabled or having end stage renal disease. Medicare Part A covers hospitalization. most people qualify to get Medicare Part A without a premium by working for at least 10 years paying into the system. people that work for the federal government before 1987 or career military may not have enough credits to qualify for Medicare Part A without a premium.
Medicare Part B is technically optional, and available to anyone over 65 or disabled earlier, who is a US citizen and permanent resident who will pay the premium. Medicare Part B.covers outpatientcare and doctor bills. One does not have to have Medicare Part A to purchase Medicare Part B. Most people pay for their Medicare Part B premium, currently $104.90 per month for most, from their social security check.

People who qualify for Medicare Part A and Part B but who do not have the means to pay may qualify for assistance to pay their premium. Depending on their level of income, they may get assistance to pay Part A premium, and some or all of Part B.
Medicaid is a program that is funded by both the state and federal governments. Medicaid is a needs-based program. This means it is provided to people with low or no income and few assets. It is available to families, infants, anyone with low/no income - including the elderly.
If someone is eligible for Medicare, they are generally required to get Medicare to qualify for Medicaid. If one cannot afford their Medicare premium, the state will usually help them pay for it to get as much federal assistance as possible before using Medicaid /State funds.

So the short answer to your question is that someone who qualifies for Medicaid may not be eligible for Medicare. if the person is over age 65, or has been on SSDI more than two years, they are likely eligible for Medicare. if applying to Medicaid, which is for people with low income, and the person is also eligible for Medicare, they will likely end up with both.
If on Medicare only, there is no rule that someone must get a supplemental plan, but as pointed out in some answers here there are supplemental plans available and Medicare HMO plans available. most states now require that if you are receiving Medicaid benefits you must get your health care through one of their approved programs Generally these are HMOs that are specifically designed to take the Medicaid funds as premium. if you do not choose your own plan within their system, one will be assigned to you. you must use that plan and their providers to get any benefits.
As DHilBe said, if you are not age 65 or disabled, you would likely be best off starting with the Marketplace. if you are age 65 or are receiving any sort of Social Security income, you should call 1 800 772 1213 and ask about Medicare. if you are asking about help for a senior citizen, check with your local Department of Aging. if you are asking about help for someone younger or based solely on income, besides the Marketplace you can also check with your local Social Services department. your options will depend on what program the person is eligible for.
Helpful Answer (0)

My 93-year-old mother (well over age 65!) had Kaiser Advantage for her Medicare and had then qualified for Oregon Medicaid when her funds ran out to pay for her long term care.
Helpful Answer (0)

:03 AM 4/20/2015 ... SandraK63.... I don't know what a Medicare HMO plan is or First Choice...but I think when you have Medicaid, that is what or who helps pay medical espenses instead of an insurance...
I just googled this :
Individuals & Families Small Businesses LOG IN ESPAÑOL Get Coverage Change or Update Your Plan
Get Answers : People with disabilities
Supplemental Security Income (SSI) Disability & Medicaid coverage
Coverage options for people with disabilities
Social Security Disability Insurance (SSDI) & Medicare coverage
Supplemental Security Income (SSI) Disability & Medicaid coverage
Waiting for a disability status decision and don’t have health insurance
No disability benefits, no health coverage
The Marketplace application and disabilities
More information about health care for people with disabilities
If you have Supplemental Security Income (SSI) Disability, you may get Medicaid coverage automatically or you may have to apply.

If you get SSI Disability and have Medicaid

You’re considered covered under the health care law. You don’t need to get a Marketplace plan. You won’t have to pay the penalty that people without coverage must pay.

If you get SSI Disability and don’t have Medicaid

You can apply for Medicaid coverage. But whether you need to apply depends on your state

In many states, SSI recipients automatically qualify for Medicaid and don’t have to fill out a Medicaid application.
In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it.
In a few states, SSI doesn’t guarantee Medicaid eligibility. But most people who get SSI are still eligible.
If you have SSI Disability and don’t have Medicaid, you can apply for Medicaid coverage 2 ways:

Select your state from the menu on this Medicaid page for contact information.
Fill out a Marketplace application.
Answer “yes” when asked if you have a disability, and we’ll send your application to your state Medicaid office.
Helpful Answer (0)

Medicare comes in effect as 65 and everyone gets. My nephew is on SSD and he is 25. He has Medicare as his primary and medicaid as his secondary. He has Horizon. You can work and get Medicaid. The best thing is to call Medicaid. Each situation is different.
Helpful Answer (1)

I believe the only way not to qualify for medicare or medicaid is by not ever paying in any taxes.
Helpful Answer (1)

Medicaid is separate from Medicare. Medicare offers Medigap insurance plans to cover what Medicare itself doesn't cover. Medicaid is for low income.
Helpful Answer (1)

My mom does not qualify for medicaid or medicare.
Helpful Answer (0)

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter