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• ????????? (Medicare and Medicaid)???Howard County
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• ???????????? ?? MD
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????????? (Medicare and Medicaid)?? ?Howard
County ????????
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What Types of Insurance You May Have?

• Private Insurance (including visitors
  insurance) e.g. Bluecross/Blueshield
• Medicare
• Medicaid
• Healthy Howard Access Plan (available after July
  1, 2008)

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What is Medicare?

• Medicare is health insurance for people age 65 or
  older, under age 65 with certain disabilities,
  and any age with permanent kidney failure (called
  End-Stage RenalDisease).
• Medicare has
• Part A (Hospital),
• Part B (Medical),
• Part C (Medicare Advantage Plans, like HMOs and
  PPOs)
• Part D (Medicare prescription drug coverage).

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Medicare Part A

• Cover inpatient care in hospitals, skilled
  nursing facilities, hospice care, qualified home
  health care.
• Do not cover custodial or long-term care.
• Cost No monthly payment for people who or whose
  spouse paid Medicare taxes while working. If you
  are 65 or over and have not worked long enough to
  receive free Medicare Part A, you may be able to
  buy it.

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Medicare Part B

• Cover medical services like doctors services,
  outpatient care, some preventive services, and
  other medical services that Part A doesnt cover.
  
• Do not cover cosmetic surgery, health care you
  get while traveling outside of the United States
  (except inlimited cases), hearing aids, most
  hearing exams, long-term care (like care in a
  nursing home), most eyeglasses, and more.
• Cost Part B is optional.
• Most people pay the standard Part B premium
  (93.50 in 2007).
• You are usually charged a fee for each health
  care service or supply you get. For some
  services, you will pay an amount called a
  deductible before Medicare pays its part.
• Then, when you get a Medicare-covered medical
  supply or service, Medicare pays its share, and
  you pay your share, called the coinsurance or a
  copayment.

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Part C Medicare Advantage Plans private
insurance-like Medicare

• Cover All Part A and Part B coverage, Part D
  drug coverage, and extra benefits like those you
  get from private insurance.
• Cost Monthly premium generally higher than Part
  B. Costs vary by plan and the services you use.

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Medicare Part D Prescription Drug Coverage

• Cover help lower prescription drug costs
• Cost Part D is optional.
• Monthly premium varies by plans.
• Deductibles also vary by plan. No Medicare drug
  plan may have a deductible more than 265 in
  2007.
• After you have paid the deductible, you pay the
  same copayment (a set amount) or coinsurance (a
  percentage of the cost) for any prescription.
• Some Medicare drug plans have a coverage gap. You
  reach the coverage gap when you and your Medicare
  drug plan have spent a certain amount of money
  for covered drugs. While you are in the coverage
  gap, you have to pay all costs for your drugs.
  For plans with a coverage gap, the most you will
  ever have to pay out-of-pocket before you are out
  of the coverage gap is 3,850 (in 2007).

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Where can I get more information?

• www.medicare.gov
• 1-800-MEDICARE (1-800-633-4227)

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What is Medicaid?

• Medicaid (also called Medical Assistance) is a
  program that pays the medical bills of people who
  have low income and cannot afford medical care.
• Cover
• Health insurance
• Long-term care for older (nursing home)
• Supplemental coverage for low-income Medicare
  beneficiaries (e.g., payment of Medicare
  premiums, deductibles, and cost sharing).
• Medicaid is a joint federal and state program.
  Each state establishes its own eligibility
  standards, benefits package, provider
  requirements, payment rates, and program
  administration under broad federal guidelines.

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You must be to get Medicaid

• A resident of Maryland
• And a U.S. citizen or green carder holder
• And have lived in the United States as a
  qualified alien for at least 5 years
• And one of the followings
• At least 65 years old
• Disabled
• Blind
• Under 21 years old
• Caring for a related child in your home
• Pregnant
• The parents of an unmarried child under 21.
• And have low income

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How much money can I have and be eligible for
Medicaid?

• Family Size Countable Monthly Income Countable
  Assets
• 1 350 2,500
• 2 392 3,000
• 3 434 3,100
• 4 475 3,200
• 5 521 3,300
• 6 573 3,400
• (This is sample information. For updated
  information, please call Maryland State
  Department of Health or visit its website.)

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Can I have both Medicaid and Medicare at the same
time?

• Yes if you are qualified for both. 
• Medicaid program will pay your monthly Medicare
  Part B premiums for you.
• Medicaid will also pay your Medicare co-payments
  and deductibles. 
• If you are 65 or over and have not worked long
  enough to receive free Medicare Part A, the
  Medicaid program will also pay the Medicare Part
  A premium. 

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What will I need to do when I apply?

• you must go to the Local Department of Social
  Services in the city or county where you live.
• You will be interviewed by an eligibility worker
  who will ask for information about your income,
  assets, and private health insurance coverage. 
  You will be asked to prove what you say is true. 

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Where can I find information for Maryland State
Madicaid?

• For more information about Medicaid and other
  Medical Care Programs
• [phone]
• [phone]
• 1 [phone]
• 1 [phone]
• www.dhmh.state.md.us

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What will soon be available to you if you are not
qualified for Medicare and you have been legal US
resident for less than 5 years (so, not qualified
for Medicaid), but have been a resident of Howard
County for at least one year on by July 1, 2008?
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Healthy Howard Access Plan
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To qualify you must

• be a legal United States resident
• a resident of Howard County for at least one year
  
• make 300 percent of poverty level or below
• have been without insurance for one year

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Major Coverage and Cost

• Primary Care Visits 6 visits to primary care
  physician at Chase Brexton. Pay 50-85 monthly
  fee.
• Diagnostic Lab X-ray 100 provided with
  referral if performed at HCGH, Quest or by
  arrangement through Chase Brexton.
• Outpatient Prescription Drugs 100 provided when
  prescriptions are filled at Chase Brexton. 10
  fee per prescription, not to exceed 20 per month
  for all Rx. 30 fee for three-month supply of
  maintenance drugs.
• Inpatient care, Anesthesia and Inpatient Surgery
  100 provided for 300 FPL. Only at HCGH not
  provided at other facilities.

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Important Information

• Enrollment starts on July 1, 2008. The first year
  will enroll 2,000 people.
• Health care will be available October 1, 2008.
• For more information call the information hotline
  at 410-313-HELP (4357)
• http//www.howardcountymd.gov/Health/HealthMain/He
  alth_HHAccessPlan.htm

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Help with prescriptions

• Wal-Mart 4 Prescriptions
• http//www.walmart.com/pharmacy
• The Bristol-Myers Squibb Patient Assistance
  Foundation
• http//www.bmspaf.org/
• Rx Outreach Patient Assistance Program
• http//www.rxoutreach.com/rxoutr/Default2.aspx
• Partnership for Prescription Assistance
• https//www.pparx.org/Intro.php

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If you are not qualified for any of these health
plans and you dont afford private insurance,

• Go to emergency rooms if you have urgent illness.
  You will be treated equally as those who have
  insurance.
• Ask help from patient financial assistants and
  social workers in the hospital.

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Questions?

• Please visit or call your health department
  offices or visit their official websites for
  updated information.