Insurance
Integrated Care Consultants can help you understand the complexities and application of the insurances coverage.
What is the difference between Medicare and Medicaid?
- Medicare (More detailed information see http://www.medicare.gov)
The Centers for Medicare & Medicaid Services (CMS) administers Medicare, the nation's largest health insurance program, which covers nearly 40 million Americans. Medicare is a Health Insurance Program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). People who become newly entitled to Medicare should enroll during their initial enrollment period (as explained under
Signing up for Medicare). After the initial enrollment periods, the annual coordinated election period to enroll or make provider changes will be November 15 – December 31 each year. There also will be special enrollment periods for some situations.
o Part A Medicare
Hospital insurance (Part A) that helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care.
o Part B Medicare
Medical insurance (Part B) that helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance.
o Part C Medicare
Medicare Advantage (Part C) plans are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organizations under Part C.
o Part D Medicare
Prescription drug coverage (Part D) that helps pay for medications doctors prescribe for treatment.
- Medicaid
Medicaid is a program administered by each State individually and funded by a combination of Federal and State revenue.
- Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources.
- Each state has its own rules about who is eligible and what is covered under Medicaid.
- Some people qualify for both Medicare and Medicaid.
- Medicaid information for Oregon is available at: www.Oregon.gov/DHS/healthplan/tools_policy/stateplan.shtml
- Long Term Care Insurance
Long term care insurance policies are purchased and paid for by individuals to cover health care needs not covered by Medicare or other health care policies.
Information regarding these policies is available at:
www.longtermcare.gov/LTC/Main_Site/Paying_LTC/Private_Programs/LTC_Insurance/index.aspx
