MEDICAID vs MEDICARE - A Crash Course
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- เผยแพร่เมื่อ 2 มิ.ย. 2024
- Questions about medicaid vs medicare might be swirling in your head if you're a caregiver for your elderly parent. If you're under 65 years old, then you may have never been exposed to health insurance for the elderly. It's no fault of your own, but here you are, searching the internet, try to find out what's the difference between medicare and medicaid. You're not alone! After working in the health care field for over 25 years, it's painfully clear that family caregivers very often have no clue about medi-caid, medi-care; what the difference is between them, who qualifies, what they cover, and how they work together. It is confusing!
In this video I'm going to discuss everything you need to know about medi-caid vs medicare (or medi-care vs medi-cal where I live). By the end of this crash course episode, you're going to have a firm understanding of the difference between medicaid and medicare. Should you get medicaid for seniors in your life? Will they qualify? And how does medicaid mesh with medicare benefits? All these questions will be answered. What are medicaid and medicare? You'll never have to ask again!
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#MedicaidvsMedicare #medicaid #medicare #SeniorCare #FamilyCaregiver #ElderCare #Dementia
Do you get that "deer in the headlights" look when someone talks about your parent's health insurance? IT'S ALL SO CONFUSING! Take this crash course in medicare & medicaid and you'll have a firm understanding of these complicated health insurance benefits for your aging parent!
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Question: Does Medicaid cover the gaps of Medicare A, B, and D?
Wow, I truly thank you so very much. That was excellent! I wish I had you to explain many other medical matters involving important decisions 😊. Your details were nothing short of a blessing.
Oh my goodness! Thank you sooo much for this video. You explained things so well. I shared to my mother, she will be 65 next month. I am also disabled and dual eligible and you've just made our lives less stressful!
I enjoyed watching the video, it explains everything in detail, the video is very interesting and effective. Thank you and good luck with the upcoming videos.
Bradley Foster, thank you so much for your feedback, it’s so appreciated!
very helpful for me as a college social work student. thanks!
Super great video thanks!
Excellent! Exactly what I needed to learn. Thank You.
Great! Thanks!
Very helpful! Thank you!
Thanks, I’m glad you thought so!
Awesome video 😎
You know, you are the only person so far who has simplified the whole thing. Others just want to make money and more confusion. Please stay beautiful and peace be with you.👌💕👍🙏🏽
@Stanley Zulu Thanks so much! I really appreciate that feedback!
Sofia Amirpoor, thank you for making this video! Medicare part A: are you only paying the hospital deductible of $1408 + daily charges for longer hospitalization if you have NOT worked over the 10 year requirement?
Thank you so much!
My husband is going to retire soon and so we’re looking into our options and the information is TREMENDOUS! I feel overloaded with info and have so many questions, but didn’t know where to begin! This REALLY helped us! Thank you!
I’m glad it was helpful! It can all be so confusing! Good luck to your husband in his retirement!
Great!! Information.
Great Video Sofia. Thank You for making it clear and simple.
Very helpful
Glad it helped
Was confused and was getting the runaround regarding what my grandson with autism would need to do because he is 22 y/o
@Sofia Amirpoor Thanks for the video - I do have a question in regards to Medicaid - I was told that people over the age of 55 have to repay the government for many of the medical expenses. My question is, let's say someone got on Medicaid at the age of 48 and later got off it at age 57. Would the state try and be comped for those extra 2 years prior to age 55 or no? Thanks for your reply.
It sounds like your confused on who pays what between Medicare and Medicaid. No one has Medicare Part A & B without paying additionally for the supplemental insurance or “medigap” because it would cause you to go broke where you would have to go on Medicaid so if you don’t qualify for Medicaid and can’t afford the supplemental insurance you would go off Medicare and get one of the Advantage C Plans. With Medicaid it sounds like you don’t pay anything. The 1400 deductible for Part A would be if you didn’t have the Supplemental Ins under Medicare which you would never do that. If you don’t have the ten years (40 quarters) in to get Medicare, you would have to pay a monthly premium plus the 1400 deductible if you didn’t have the additional supplemental insurance. Best to be broke and get everything free with Medicaid!
Merci
You're so welcome!
I believe my mother has been mentally ill her whole life but never diagnosed. 3 years ago it was determined that she had mild dementia -likely Alzheimers type and I am trying to have her assessed again next week since she is clearly much worse. My Mother has been mentally and verbally abusive to my sister and I our entire lives. After we became adults and moved out, My Father has been being abused in the same cruel way for many years since they live in the same house alone. My brother ( who has never helped in anyway) is her favorite and the only person who she seems to love. She wants to go live with or near him in California. My parents live in Florida and I manage their finances and all their needs, (not an easy task at al)l. I recently had to take my Dad's car away ( 4 accidents, etc) which has caused a lot more stress and problems. I've hired an assistant to drive them to Doctor apps and groceries. My Mother wants to live in CA and my Dad would love to finally be free of her abuse. How is this done? Does she have to establish residency to be eligible for Medical? She refuses to go to an ALF here but might do it if she can be near my Brother in CA. It all is very confusing.
Hi Cindy, I hope this situation gets resolved for you and your Dad soon. Moving medicaid between states can be complicated. Yes she needs to establish residency in California (permanent address) before she can apply and applying should be made a priority once she gets here. The Florida medicaid cannot be used in California, but hopefully she has medi-care and that can be used in any state. If she needs to pay for any healthcare out of pocket before getting medi-cal, keep receipts and can possibly be reimbursed once medi-cal is in place as it can possibly be retroactive to the date she moved if it was applied for in a timely manner, I think you have 90 days....but do it sooner. Know that just because she qualified for medicaid in Florida doesn't necessarily mean she will qualify for Medi-cal since they have different eligibility criteria. And in all honesty, I don't know if Dads income/assets will be counted in her medi-cal eligibility since they are still legally married. Here is the service # for medi-cal and a live person usually answers and can answer that question: (800) 541-5555 (outside of California, please call (916) 636-1980). Most who qualify for medi-cal are not able to afford the assisted living facilities here in California, unless family helps. Medi-cal does have a waiver program for assisted living, however, there is a waiting list and you don't necessarily get to choose the facility. You choose the county (not all counties participate), and you have to be willing to move to the facility that happens to have an opening in the county when you are up on the list. Here is link to the medi-cal waiver program for more info: www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx
I hope your family can figure this out. Keep me posted, I'd love to hear about the outcome. Meanwhile, I recommend you take a look at this video about caring for an abusive parent, it might be helpful: th-cam.com/video/ylfJNhvEfQM/w-d-xo.html
Best wishes.
@@SofiaAmirpoor I saw both videos and they were very good. How in the world can we establish residency for my Mother since she has to be cared for in a me
mory care facility? My Brother isn't equipped or interesting in having her live with him in his home so I don't know how that could happen. Doesn't it take a year or 2 to establish residency? What if I died and there was no one here to care for her?
It's a hard situation. No, as far as Medi-cal is concerned, residency occurs the moment she moves into the state and has a permanent address. I know it's a difficult option, but family may need to pay for memory care until the waiver kicks in, however, that can take years....nearly impossible for most families. The other option is nursing home care near your brother. You might be able to call around to see if any are willing to take her with Medi-cal pending. It really depends on how low their census is....if it's really low, they may be more apt to accept her knowing that they will get paid retro. But the majority may not consider it. and many nursing homes don't ever take long term medi-cal at all. Unless your brother is willing to take her in, at least temporarily, you may not have many options.
Thank you. Is there a discussion on Medicaid and the pay back topic? Is payback from an estate required only when enrolled in long term Medicaid (for nursing home care) or is payback required from regular Medicaid for as long as someone is enrolled? I’m unable to find this answer directly anywhere.. I hope I’m asking this clearly enough! Again thank you.
Depends on your state.
Hi, i am 67y old man how has Medicare Plan A. Since I lived outside of US untill recently did not apply for Plan B. Since my SS benefit is very low am I eligible for Mecidaid? Also do I need to apply and enroll in Plan B first then apply for Medicade.
Thanks
It seems that sometimes Medicaid is better than Medicare or private insurance. You may call Medicare or your private insurance company and ask if something such as hearing aids, eye glasses, medical alert systems are covered and they say No, No, No, however Medicaid often covers these devices. I think there should be a law that says if Medicaid covers it, the Medicare and private insurance should cover it.
People don't want to pay the premiums needed for that.
@@SandfordSmythe People who pay premiums often pay more for items than people who don't pay premiums.
@@deborahd.7281 I'm not sure of your point. If Medicare B is raised another $50 or $100, there will be complaints.
@@SandfordSmythe My general observation, it may not be a complaint, is that people who pay their private insurance premiums pay more co-pay for their prescriptions than people who get government paid benefits and may get their prescriptions for free. There are government programs where if you earn a little too much, or work a little too much you are not eligible. It in a way it discourages work and earning more.
@@deborahd.7281 This is the classic criticism of "Welfare". I don't have an easy answer, but I won't trash it.
What is mean of 10 year in the system in the Medicare ? Please suggest
It means that you need to have worked in the US for at least 10 years and had the appropriate deductions taken from your paycheck during that time in order to qualify for Medicare. Hope that helps!
Thank you for some good information. SUGGESTION: Please stop addressing the audience as parent caregivers. It is condescending. Your audience includes us seniors… yes we are out there with intelligence and ability to act for ourselves. 😉
That’s her target audience. Nothing condescending about it. You’ve got a giant chip on your shoulder.
About the Medicare - I still don't understand ...how does one decide which option A,B,C to use ?
Hi Amy. That's such a good question! You don't really have to decide. For A & B, the provider will bill it to Medi-care appropriately. No one will ever ask you whether you want to use A or B, they will just do it. (Assuming you have both A & B) As for C, when it is time for open enrollment, if you sign up for a medi-care advantage plan, then you are using C....but again, no one will ask you if you want to use C. I hope that helps!
Can you kindly clarify what '10 years working in the system' refers to? The system? Thank you !
Yes, I’m sorry I guess that was kind of vague! What I mean by working into the system is that in order to get Medicare benefits here in the United States a person has to work a minimum of 10 years At a legitimate job, where they pay taxes and Social Security, and of Medicare is also withheld from their paycheck, and that has to be done for at least 10 years in order for them to be eligible for Medicare later.
Hello Sofia, thank you for the information. I'm still so confused. I'm trying to help my father he is 70 years old, he has medicare part A& B his medicaid was cancelled I don't know why because he is on a low income, he has to pay for the medicine he gets every month please help me out and let me know what he needs to apply for so he doesn't have to pay a lot of pocket, he might also need to get help from a nursing home. Please help as I'm very confused I thought Medicare cover for everything now I learn he also might need Medicaid, and supplemental plan?
Oh no, what a mess! First, call the Medicaid or the Medicaid worker to find out why it was cancelled. Either he had a change in his income/assets or the annual redetermination paperwork was not submitted on time...this is very often the case. It frequently gets lost in the mail if there was a move or change of address. If this was the case, ask them to resend paperwork and get it submitted ASAP. If they receive it soon enough, it might reinstate retroactively. Save all receipts for meds or care and if Medicaid is retro activated, you can request reimbursement. For now, Medicare may pay for skilled care at a nursing home if he meets criteria, but days are limited and there’s co-pays. If there is no skilled need, and it’s custodial level of care, Medicare will not pay, so be careful. I’d work on figuring out the Medicaid as a priority. Good luck!
The cost of a nursing home will make him eligible for Medicaid
? I had Gateway insurance and I was told gateway changed their name to highmark whole care and now it says I have Medicaid...You kept saying "your parent" are you able to help me understand what that is to mean? I am sorry I do not understand what you mean
Thank you so much for explaining this process, I'm late but better then not knowing. Keep up the awesome information that can help everyone. You are so BUT-TA & BUT-TA is good right? You like Butter? Then you BUT-TA. That mean you good.😁😄😄😄
@Cassandya McKinney Thanks! You crack me up!
Hi Sofia this is Pramod KUMAR i wanna discuss something about RCM. I working in AR
If my mother is on medicare/ medical can I get paid as a caregiver for her?
Yes you can in California. Apply for In Home Support Services for her. You will need to register as a worker and maybe go through basic training. Then you can be paid
HELP PLEASE! I'm freaking out because I'm on disability and medicaid is being cut off in Dec. and i am being put on medicare instead. Is medicare or medicaid better? with medicare i have the original medicare plan is that the best or should i get medicare advantage?? i live in louisana. Thanks any/all people who answer this. i have bad mentality and scared
Hi there. Try not to be stressed, I'm glad that you have some type of insurance! Usually, medicaid is not stopped just because medicare starts, you can have both at the same time, which is great coverage. Maybe there is a reason they are stopping medicaid....such as a change in your income/social security payments? They should have sent you a letter explaining why it was going to be stopped. If you still have questions, call your medicaid worker and ask. As far as which is better, medicaid or medicare, they are different and it's too much to explain here, but if you watch that video, I explain them pretty clearly. Medicare Advantage plans are great for some people because they would greatly reduce your out-of pocket expenses compared to regular medicare. However, if you are a low utilizer, or if the medicare advantage plan's providers are too far away from your home, then maybe it's not the best for you. There is no one right answer for everyone, that's why there are options. I found this agency in Louisiana, it's a free health insurance counseling program for medicare recipients. Every state has an agency like this. Here is the one for your area, they may be able to help you further. Good luck to you. www.ldi.la.gov/consumers/senior-health-shiip
@@SofiaAmirpoor thanks for responding!! things may have worked out. mom talked me into calling GOMEDICARE and they found me a really good deal that will run $36/month, humana value plus ppo . mom and grandpa both went through them years ago and love the plans they on. it sounds really good im just crossing fingers and hoping i dont get another denial letter like i did with medicaid. in past i always took healthcare for granted, but have realized how important having it is. was sickly some yrs ago and didnt have insurance to see dr when i needed.
What is spendownfor Medicare to qualify for mefica
If my mom is in California nursing home and has Medicare advantage and Medicaid full benefits, would I, family, still be billed by nursing home for part of stay? My mom is giving them her SSI and they still are asking for $1000 each month more. My mom is low income, 78 and needs long term care.
Hi Laura. The only things that I can think of that would warrant the extra charge is if your mom has a medi-cal share of cost of $1000, or is in the spend down phase, or if she is using her medicare skilled days and the facility is not contracted with the advantage plan. You certainly have a right to understand what you are being billed for, so ask the business office, which you probably already have done since I took so long to respond (sorry about that!). I'd be curious to know what they said, let me know!
@@SofiaAmirpoor its not medical. I am going to contact medicaid next week and I will let you know what I find out. I plan on moving her to Arizona in a month or two.
Hi Laura, you said you mom was in California...I live here too. Here, Medicaid is called
medi-cal, it’s the same thing. Good luck
Is Medicaid in Massachusetts called mass health?? Thanks
Yes it is.
What is system? You mentioned
Social Security
Sofia how can I contact you please? Where are you located?! Thanks
Hello Pri USA. You can contact me through my website www.SofiaAmirpoor.com
I am in Southern California
I'm Willie E willingham on SSDI needing help, living income benefits not even $800 monthly
broken system.. so happy not to live in the USA!
You're probably right! It's all we have...for now!
@@SofiaAmirpoor my heart is with you, good luck for the elections!! changing is due
Very helpful
Glad you think so!