The Older Americans Act – Medicare/Medicaid

The Older Americans Act (OAA) was enacted in 1965 along with Medicare and Medicaid as part of a historic effort by lawmakers to care for those age 65 and older. According to Tamara Lytle of the American Association of Retired Persons (AARP), the OAA has been a safety net, filling in the gaps left by Social Security and Medicare to help people live independent lives. It’s seven primary sections include home-delivered meals; such as meals on wheels, family care giving support, transportation to medical appointments, elder abuse protection and job training.

Medicare and Medicaid are two very different programs. Medicare is intended to provide health care to the elderly and/or disabled, whereas medicaid offers healthcare to low income persons that includes: children, pregnant women, parents, seniors, and individuals with disabilities. According to Tanya Feke, MD of Verywell Health http://www.verywellhealth.com, millions of Americans are eligible for both programs, and 8.3 million according to the Centers for Medicare and Medicaid. These beneficiaries are referred to as dual eligible and understanding how the programs work together will help you make the most of your healthcare experience.

Dual Eligibility Criteria – Medicare

• Is the same regardless of where you live
• Is set by the Federal Government
• Must be 65 years or older or have a qualifying disability
• Must meet U.S. citizenship or permanent legal residency requirements

Dual Eligibility Criteria – Medicaid

• Varies geographically
• Minimum program requirements set by Federal Government
• Program is run by individual states
• Each state has option to adjust their eligibility standards

Medicare covers medically necessary care for ‘acute care’, such as doctor visits, drugs, and hospital stays. Generally, Medicare pays first and Medicaid pays second. However, the amount paid by Medicaid has a limit that is set by each state. When doctor prescribed, Medicare also pays for part-time or intermittent skilled nursing care; physical therapy, occupational therapy, and speech-language pathology provided by a Medicare-certified home health agency. Go to http://MedicarePlan.com or call (844) 889-4244 to compare plans statewide quickly and for free by just entering your zip code.

Prescription Drugs Costs – Medicaid requires that you sign up for prescription drug coverage through Medicare, i.e. Part D plan or Medicare Advantage plan with prescription drug benefits (aka MA-PD plan). Some medications not covered by your Medicare plan is usually covered by Medicaid.

To locate a network of primary care practices for adults on Medicare, contact #Oak Street Health at http://Oakstreethealth.com or call (844) 871-5650.

How has the Older Americans Act or Medicare/Medicaid impacted you or the care of your loved one?

Contact Kimberly Richardson at info@50plusshadesofus.com or connect with me at https://50plusshadesofus.com.