Medicare and Medicaid

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Medicare

Medicare is a federal health insurance program generally for people age 65 or older who are receiving Social Security retirement benefits. Medicare covers inpatient hospital care and a portion of the doctor’s fees and other medical expenses. There are specific eligibility requirements in order for a person to receive assistance from this program. Medicare covers some, but not all, of the services a person with Alzheimer’s disease or a related dementia may require. Applications for Medicare may be sent to a local Social Security office.

Medicare Web sites:

Medicare Web site
This Web site for both the consumer and the health care professional includes frequently asked questions and information on local Health and Human Services offices.

Ask Medicare
Medicare's site to help family caregivers — those who are family members or friends who help people with Medicare — access and use valuable health care information, services and resources.

Medicare Basics for Caregivers
Online version of Medicare's booklet, "Medicare Basics: A Guide for Families and Friends of People with Medicare."

Medicare and the new Health Law

Important Information on the $250 rebate for Medicare Beneficiaries who enter the Coverage Gap ("donut hole")

Fact Sheet: The $250 Rebate for Beneficiaries Who Enter the Coverage Gap

The Center for Medicare and Medicaid Services (CMS) has prepared a brochure that explains some of the changes to Medicare that are in the new health law.

Medicare and the New Health Law – What it Means for You (English)

Medicare and the New Health Law – What it Means for You (Spanish)

Medicare topic sheets from the Alzheimer's Association:

Medicare: An Outline of Benefits (4 pages)

Fee-for-Service Medicare (6 pages)

Medicare Hospice Benefit: Frequently Asked Questions (2 pages)

What Can a Beneficiary Do if Medicare Refuses to Pay for a Medical Service? (1 page)

Medicare Savings Programs: Assistance with Meeting the Costs of Medicare Premiums and Deductibles (2 pages)

Medicare Home Health Benefit for Caregiver Training in 16 States (2 pages)

Medicare Drug Coverage

Medicare prescription drug coverage is available to all people with Medicare. For information and resources, see our Medicare Drug Coverage page.

Medigap

Medicare coverage can be supplemented with Medigap, a private insurance that covers copayments and deductibles required by Medicare. The more expensive policies may cover prescription drugs.

For more information, visit Medigap's Web site.

Medicare HMO (Medicare Managed Care)

A Medicare HMO offers some additional benefits and less paperwork in exchange for restrictions on choices of hospitals, doctors and other professionals. Most Medicare HMOs cover nursing home and home health care for limited periods only under special circumstances.

For more information, visit Medicare’s Web site.

Medicaid

Because Medicaid is a federal program typically administered by each state’s welfare agency, eligibility and benefits vary from state to state. The program is typically administered by a state welfare agency. Medicaid covers all or a portion of nursing home costs. A person with Alzheimer’s can qualify for long-term care only if he or she has minimal income and cash assets.

For more information, visit the Medicaid Web site.