Page 12 - Senior Times South Central Michigan - March 2018 - 25-03
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Page 12 Senior Times - March 2018
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services. You may also be eligible for extra help paying for Medicare prescription drug coverage (Part D), even if your income exceeds Medicaid income levels, under the spend down rules if you are medically needy.
Medicaid spend down
Even if your income exceeds Medicaid in- come levels, you may be eligible under Medic- aid spend down rules. Under the "spend down" process, some states allow you to become eligible for Medicaid as "medically needy," even if you have too much income to qualify. This process allows you to "spend down," or subtract, your medical expenses from your income to become eligible for Medicaid. To be eligible as "medically needy," your measurable resources also have to be under the resource amount allowed in your state.
Dual Eligibility
Some people who are eligible for both Medi- care and Medicaid are called “dual eligibles.” If you have Medicare and full Medicaid cover- age, most of your health care costs are likely covered. You can get your Medicare cover- age through Original Medicare or a Medicare Advantage Plan (Part C). If you have Medicare and full Medicaid, you'll get your Part D pre- scription drugs through Medicare, and you'll automatically qualify for Extra Help paying for your Medicare prescription drug coverage (Part D). Medicaid may still cover some drugs and other care that Medicare doesn’t cover.
PACE (Program of All-inclusive Care for the Elderly) is a Medicare and Medicaid program that helps people meet their health
care needs in the community instead of go-
ing to a nursing home or other care facility. PACE covers adult day primary care, den- tistry, emergency services, home care, hos- pital care, laboratory/x-ray services, meals, medical specialty services, nursing home care, nutritional counseling, occupational therapy, physical therapy, prescription drugs, Part D covered drugs, preventive care, social services, caregiver training, support groups, respite care, social work counseling, and transportation if medically necessary.
With PACE, the focus is on you – you have a team of health care professionals working with you and your family to make sure you
get the coordinated care you need. When you enroll in PACE, you may be required to use a PACE-preferred doctor. These doctors are best suited to help you make health care decisions. If you don't have Medicare or Medicaid, you can pay for PACE privately. Note: You can leave a PACE program at any time.
MI Choice Waiver
Nursing homes used to be the only choice for older or disabled persons who needed help caring for themselves. Today there may be the choice to stay in your home or a community setting, but you or a family member may need assistance in doing so through the MI Choice Waiver Program.
Through this program, eligible adults who meet income and asset criteria can receive Medicaid-covered services like those provided
by nursing homes, but can stay in their own home or another residential setting.
Nurse and social worker teams work with participants to develop a person-centered, indi- vidualized plan that includes a mix of services appropriate to their needs and preferences. Each participant can receive the basic services Michigan Medicaid covers and more. To find a MI Choice Waiver Program in your area reach out to your Area Agency on Aging to get started.
Medicare Savings Programs
Medicare Savings Programs (MSP) help pay your Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments, and Medicare prescription drug coverage costs. You may qualify for
the Qualified Medicare Beneficiary (QMB) Program, Specified Low-Income Medicare Beneficiary (SLMB) Program, Qualifying Individual (QI) Program, or Qualified Disabled and Working Individuals (QDWI) Program, even if your income and resources are higher than the state limits.
If you qualify for a QMB, SLMB, or QI pro- gram, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage.
Save on Drug Costs Too
You may qualify for extra help from Medi- care to pay the costs of Medicare prescription drug coverage if you meet certain income and resource limits. If you have Medicaid, get help paying your Part B premiums (Medicare Sav- ings Program), or get Supplemental Security Income (SSI) benefits, you automatically qualify for extra help. Contact your Medicaid office for more information.
For more details on any of these programs supported by Medicare call 1-800-MEDI- CARE (1-800-633-4227).

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