Understanding Medicare and Medicaid with Legal Help

Medicare and Medicaid are very different medical insurance programs. The words are not interchangeable, yet you might hear people make that mistake and talk about them as though they are. If you attempted to apply for one program and failed, there’s a good chance that you either applied to the wrong program or you didn’t qualify. A lawyer can help.

Medicare is the government-sponsored health insurance program for elderly and disabled people. Retirees that have reached the right age required can also buy into Medicare. You do have to pay a monthly amount to have Medicare coverage, but it’s usually not as expensive as a single prescription medication. If you take a lot of different medications as an elderly or disabled person, then Medicare Part D for drug coverage is a lifesaver. Medicare does not cover long-term care.

Medicaid in 49 of 50 states is the state-sponsored medical insurance for low-income and no income individuals. In some states it also covers children to a certain age at zero cost to low-income families. For children with disabilities, this state insurance program covers them until age 18 free of charge or with reduced monthly charges.  There are other state programs that rely on Medicaid funds to help provide long-term care for those that qualify. This includes nursing and assisted living homes.

Age requirements for each of these programs is very specific. If you don’t fit the age requirement, that might have been the problem. If you don’t fall within income guidelines, that might also have been the problem. Having a documented disability and considered disabled by Social Security standards may dictate your qualification too. Lastly, another barrier to state Medicaid is having previous coverage that ended. States often make you wait up to three months after losing medical insurance from employment. 

A lawyer can show that you cannot be without insurance. Undue financial hardship due to medical bills and medication or medical equipment is key. The lawyer can argue that you need the insurance sooner or that you need it cover extensive medical bills. 

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