What is Medicare?
Medicare is federal health insurance plan for people 65 or older, and some people under 65 with certain disabilities or conditions. A federal agency called the Centers for Medicare & Medicaid Services runs Medicare. Because it’s a federal program, Medicare has set standards for costs and coverage. This means a person’s Medicare coverage will be the same no matter what state they live in
What is Medicaid?
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. This means eligibility requirements and benefits can vary from state to state. Medicaid offers benefits that Medicare doesn’t normally cover, like nursing home care and personal care services. People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or services.
Who’s Eligible for Medicaid?
In all states, Medicaid gives health coverage to some individuals and families, including elderly people with certain incomes, and people with disabilities. Some states have expanded their Medicaid programs to cover other adults below a certain income level.
SLMB vs. QMB Types of Medicaid in Texas
To qualify for the SLMB (Specified Low-Income Medicare Beneficiary) Program. You need to have limited financial resources. This means that when you add up all of your resources as an individual, those should value no more than $9090. As a couple, your maximum countable resources should be $13,630.
QMB (Qualified Medicare Beneficiary) covers the cost of 1. Medicare Parts A and B monthly premiums and 2. Payments of coinsurance and deductible amounts for services covered under both Medicare Parts A and B. Typically, you should not be billed for Medicare-covered services when seeing Medicare providers or providers in your Medicare Advantage Plan’s network.
All information for this article is from the Texas Health and Human Services website, www.hhs.texas.gov. For more information on applying and to understand Medicaid, please call the Texas Department of Health and Human Services at 211 Texas or 877-541-7905.
Ms. Lamonica Thomas is a license agent specializing in assisting Medicare enrollment participants. Her articles will appear monthly through December. Reach her at: La-monica Thomas <latho-mas55@gmail.com> or call 972.249.8907.
