Medicare and Medicaid

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Medicare
Medicare Drug Coverage
Medigap
Medicare HMO
Medicaid
Medicare Advocacy Project

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Medicare

Medicare is a federal health insurance program generally for people age 65 or older who are receiving Social Security retirement benefits. Medicare covers inpatient hospital care and a portion of the doctor’s fees and other medical expenses. There are specific eligibility requirements in order for a person to receive assistance from this program. Medicare covers some, but not all, of the services a person with Alzheimer’s disease or a related dementia may require. Applications for Medicare may be sent to a local Social Security office.

Medicare resources:

Medicare Web site
This Web site for both the consumer and the health care professional includes frequently asked questions and information on local Health and Human Services offices.

Medicare: An Outline of Benefits (4 pages)

Fee-for-Service Medicare (6 pages)

Medicare Hospice Benefit: Frequently Asked Questions (2 pages)

What Can a Beneficiary Do if Medicare Refuses to Pay for a Medical Service? (1 page)

Medicare Savings Programs: Assistance with Meeting the Costs of Medicare Premiums and Deductibles (2 pages)

Medicare Home Health Benefit for Caregiver Training in 16 States (2 pages)

Medicare and Medicaid Costs for People with Alzheimer's Disease (24 pages)

Medicare Drug Coverage

Medicare prescription drug coverage is available to all people with Medicare. For information and resources, see our Medicare Drug Coverage page.

Medigap

Medicare coverage can be supplemented with Medigap, a private insurance that covers copayments and deductibles required by Medicare. The more expensive policies may cover prescription drugs.

For more information about Medigap, go to Medicare’s Web site.

Medicare HMO (Medicare Managed Care)

A Medicare HMO offers some additional benefits and less paperwork in exchange for restrictions on choices of hospitals, doctors and other professionals. Most Medicare HMOs cover nursing home and home health care for limited periods only under special circumstances.

For more information, visit Medicare’s Web site.

Medicaid

Because Medicaid is a federal program typically administered by each state’s welfare agency, eligibility and benefits vary from state to state. The program is typically administered by a state welfare agency. Medicaid covers all or a portion of nursing home costs. A person with Alzheimer’s can qualify for long-term care only if he or she has minimal income and cash assets.

For more information, visit the Centers for Medicare and Medicaid Services Web site.

Medicare Advocacy

Alzheimer's is an epidemic that is driving Medicare costs out of control because the program does not pay for the chronic care that could prevent expensive but avoidable health care crises and excess disabilities.

Medicare expenditures for people with Alzheimer's are higher than the average for all beneficiaries. Within a decade, total annual Medicare costs for people with Alzheimer's will increase 75 percent — to nearly $160 billion.

The Medicare Advocacy Project, initiated by the Alzheimer's Association in collaboration the American Bar Association's Commission on Legal Problems of the Elderly, was developed to respond to various problems encountered by Medicare beneficiaries with Alzheimer's disease.

To learn more, see our Advocacy section.