The Differences Between Social Security Programs, Part 2

This blog is a continuation from The Differences Between Social Security Programs, Part 1.

Medicare Enrollment FormMedicare is a health insurance program for persons 65 and over and for some disabled. Income is not an eligibility factor. Medicare is linked to Social Security benefits, and coverage is broken down into different parts:

  • Medicare Part A (Hospital Insurance).
  • Medicare Part B (Medical Insurance).
  • Medicare Part C (Medicare Advantage Plans).
  • Medicare Part D (outpatient prescription drug coverage).

Each part of Medicare covers a specific service. These range from inpatient hospital stays to prescription drug coverage, and Medicare Medical Savings Account Plans to care in a skilled nursing facility.

Medicare Part A is free to most beneficiaries and covers hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B is an optional premium based plan and pays for physicians and outpatient services, as well as medical equipment. It also covers lab tests, x-rays, and mental health care.

Medicare Part C is now part of a Medicare policy which allows private health insurance companies to provide Medicare benefits. You choose a plan called Medicare Advantage Plans, instead of the original Medicare for parts A and B.

You may pay a premium and can also obtain Part D coverage under the plan you choose.

Medicare Part D provides for outpatient prescription drug coverage.

Premiums for Part B and Part D depend on a beneficiary’s income. Beneficiaries with higher incomes will pay higher premiums.

The Social Security Administration reviews a beneficiary’s most recent federal tax information in order to determine what their premium will be.

If you wish to qualify for Medicare, you must either receive Social Security Retirement benefits or Social Security Disability benefits. Your application will be processed by the Social Security Administration.

Medicaid is a joint federal-state program of medical assistance to eligible needy persons. It provides health coverage to children, pregnant women, parents, seniors and individuals with disabilities.

In order to participate in Medicaid, federal law requires states to cover certain population groups, called mandatory eligibility groups, and also gives them the flexibility to cover other population groups, called optional eligibility groups, such as aged, blind and disabled individuals, and medically needy persons.

Many states have expanded coverage, particularly for children, above the federal minimums. For many eligibility groups, income is calculated in relation to a percentage of the Federal Poverty Level (FPL), which is updated annually.

For other groups, income standards are based either on income, or other non-financial criteria standards for other programs, such as the Supplemental Security Income (SSI) program.

There are a few Social Security disability beneficiaries who are able to receive Medicaid benefits as well as Medicare insurance benefits. These disability beneficiaries generally have monthly benefits that allow them to be entitled to both SSI and SSD disability simultaneously, or they have Social Security disability benefits that are low enough to receive Medicaid even though they are too high for SSI disability entitlement.

To read more about the different types of Social Security programs, please see Part 1.

To learn more about whether you qualify for a Social Security program or to begin your estate planning process, please contact us at Aaron J. Goldberg, PLC.

 

 

“Used with permission 2016”

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Attorneys with Aaron J. Goldberg, PLC are members of the Vermont Bar Association and the National Academy of Elder Law Attorneys.