OCR Text |
Show " .--! : I Medicare, Mediade Benefits Explained. Medicade Is Medical Assistance )1 . By TOM BUSSELBERG n FARMINGTON - No, Medicare and Medi-,,aid Medi-,,aid are not the same thing, although people get inem confused, it seems, constantly. -eat-' D.'CARE is explained in the accompany-10-'h article, and is an insurance-something after. ov. caid definitely is not, says Bonnie Con- ne-;k he Dav's County Council on Aging. "It iwde i edlcal assistance for the low-income-for nH fewho need helP-" arccn , s further from its closely-named "unterpart, in that federal, state and local s combine in financing it, with the feds nteriff'to th'"8 'f 3 sizeable portion, ranging from half ilpre st'" 'ourths, varying with a state's income. wW at x D 29 years a8' a" states n0W per" ' ifesi , "e,a Medicaid program but every one is slight- fjei I a'"erent, contrasting from the uniform Med- Mr.I. aJ.e setup. Each state operates its own, she riVsu k meaning usually only in emergencies, The 55 an ,has accidents, can coverage be allowed in I hni r state or arrangements made in state o)$- "order areas. k hsi'irJt?,?alify for coverage, a single person earn-? earn-? lifl!i; cn, , 4 a montn would be eligible while a facii viCPP e earn'ng $405 could participate. "Ser- A,&rnp . are Prov'ded only when certain require-J require-J Vn , .are met- You need a primary doctor to Tnic: th, Clpate'" for medication, where he'd write dop ne prescription and place the order. u,vrbiiA?TlCIPATING physicians are reim- Vtorv- one-hundred percent, but "a lot of doc-g'n doc-g'n r-add aren,t involved, Ms. Conover said, jV-nef'eoi.!"8 that before hospitalization or medical S5i"' ulPment is purchased with program financial assistance, prior approval is needed. The State Division of Social Services oversees the program prog-ram in Utah. For those with Medicare, Medicaid usually will pay no part of the costs for covered medical medic-al expenses with a small co-payment sometimes some-times required. For some, though, Medicaid will pay Medicare premiums and deductables and also may reimburse for those parts of medical expenses not covered by Medicare but included in a state's Medicaid program. MEDICAID was originally designed to help out in "catastrophic" health emergencies, explained ex-plained Joyce Smith, Golden Years Center director in Bountiful. If a person with a $425 monthly income-above the minimum allowable allow-able for a single person-incurred a $20,000 medical bill, he'd pay the $1 19 a month difference differ-ence down to allowable income and then the remainder would be paid-a lot better than the whole bill, she emphasized. A person needing assistance only has to contribute con-tribute into it until his medical bill's paid off, paying with the insurance card in hand for proof to the provider whether it be physician or pharmacist, etc. PARTICIPANTS can own their own home and automobile but other "negotiable assets" must not top $1,500, Mrs. Smith explains, indicating in-dicating most area physicians do participate. Citing it is an advantage for them, she notes that while only 10 percent of the population is over 65, 29 percent of all medical bills come from that age group. Calling it an "assistance program" she said further information is available by calling 533-6751 533-6751 in south county or toll-free 1-800-662-9651 in north county. Medicare Is A Federal Health Insurance Program I By TOM BUSSELBERG i j FARMINGTON - The term Medicare has become common in j America within the past 18 years, : but there's still confusion between I it and Medicaid with that program i explained briefly in the accompanying accom-panying article. AS OUTLINED by Bonnie Con-over Con-over of the Davis County Council 1 on Aging, Medicare is a federal ' health insurance program for those : 65-years of age and older plus disabled dis-abled covered by Social Security ! disability or kidney and other dialysis di-alysis patients. Funds come from a federal trust fund with the program including two phases: hospitalization insur-: insur-: ance and medical insurance. The medical insurance must be applied ! for at the Social Security office three months before your 65th birthday, she explains. THE hospitalization-skilled care facility program is paid from Social Security garnered while a person's working. The medical insurance-if desired-must be paid for at the rate of $14.60 a month although that'll be rising slightly come January. Enrollment is open January-March of each year. Under the hospitalization portion, por-tion, if a person requires hospitalization, hospitali-zation, Medicare will cover the allowable services from the 1st-60th 1st-60th hospital day and those don't have to be consecutive, she stressed. stres-sed. That comes after a $365 de-ductable de-ductable payable for that first hospital hos-pital day, but that'll be increased to $400 in January. THE GOVERNMENT'S broken benefit payment periods into "benefit "be-nefit periods" of 60 days. If you use up only 20 days of the first 60 days, for example, you still have 40 days and don't have to pay another deductable. After that first 60 day benefit period, you can start another period. If you must utilize all of those and still aren't well, Medicare Medi-care will pay another 30 days, Ms. Conover said, but then you're required re-quired to pay an $89 a day co-payment, co-payment, covering a 90 day period. AFTER THAT three months, Medicare "basically runs out" for hospitalization but there's a lifetime life-time 60 day reserve that could be used when needed although it's not renewable, she stressed, adding those could all be used if needed after the other days had been exhausted. ex-hausted. : The option of using only part of ; that 60 days in each "benefit j period" is helpful, allowing some- : one to recuperate at home, for ex- : ample, although 150 consecutive ; days could get costly, Ms. Conover : said, emphasizing "most don't need that long usually they're : done in much less time." SKILLED nursing care is in : eluded in coverage, as well, such as if a hip fracture or osteoperosis. If : someone's been hospitalized and : then needs rehabilitative skilled ; nursing care, Medicare pays for up to IOOdaysinanursjnghome. That doesn't include "custodial care," : however, but normally after some- : one's placed in a nursing home. Medicare will continue -coverage for the first 20 days and then a. j $44.50 payment is required from : the 21st-100th day. As with all government prog-' rams, seemingly, the skilled nurs-' ing care coverage can't receive : coverage unless the patient's been : hospitalized for at least three days i prior. Even respite care is covered if the patients at home, allowing ; family or others assisting some re- ' lief at reduced cost. r |