Medicare (Original Medicare and Medicare Advantage)
U.S. Centers for Medicare & Medicaid Services
Medicare is the federal health insurance program. Original Medicare is Part A (hospital insurance) plus Part B (medical insurance). It lets you use any doctor or hospital that takes Medicare, anywhere in the U.S., meaning all 50 states, DC, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. With Original Medicare you can add a separate Part D drug plan and buy a Medigap (Medicare Supplement) policy to help cover the 20% coinsurance and other out-of-pocket costs. Medicare Advantage (Part C) is an alternative run by private health plans that Medicare approves. These plans bundle Parts A and B and usually Part D, often with extra benefits like vision, hearing, and dental. They typically use a network and require approval ahead of time for some services. They have a yearly cap on out-of-pocket costs, so you do not need Medigap.
Who qualifies
What it covers
Cost
How to apply
Where to go from here
Adult Day Center
Adult day centers are daytime programs for adults who need some level of supervision and care but not skilled nursing or rehabilitative therapy. Services typically include personal care, social activities, education, routine health monitoring, therapeutic activities, meals and snacks, transportation coordination, first aid, and emergency care.
Adult Day Health
Adult day health is a daytime program for adults who need skilled nursing care or licensed rehabilitative therapy. Centers provide skilled nursing services, physical/occupational/speech-language therapy, brief psychological or counseling services, plus the personal care, meals, social activities, and health monitoring offered at adult day centers.
Apple Health Classic Medicaid (SSI-related / Aged, Blind, Disabled)
"Apple Health" is Washington's name for all of its state medical assistance programs, including Medicaid. "Classic Medicaid" is the part of Apple Health for people who are 65 or older, blind, disabled, or who need long-term care. These programs count your income the same way Supplemental Security Income (SSI) does, rather than using the tax-based rules that apply to younger adults and families. The state Health Care Authority runs most Apple Health programs. The Department of Social and Health Services (DSHS) runs SSI-related coverage, the state-funded Medical Care Services program, and the Medicare Savings Programs that help pay Medicare costs. If you have both Medicare and Apple Health, Apple Health acts as your second layer of coverage and picks up costs Medicare does not, such as deductibles, copays, hearing aids, and dental. It can also pay for long-term care.
Apple Health for Workers with Disabilities (HWD)
Apple Health for Workers with Disabilities lets working adults age 16 or older who are blind or disabled buy into Medicaid. It provides full Apple Health coverage. Unlike most disability-based Medicaid, it has no asset test and no upper income limit. You qualify based on your disability (using the federal disability rules) and being employed, full or part time, including self-employment. You pay a monthly premium that goes up with income but never goes above 7.5% of your total income. American Indians and Alaska Natives pay no premium. While you are enrolled, you can put earnings into a separate designated account that will not count toward your eligibility for other Medicaid programs.
Not sure this one fits your situation? Your local Area Agency on Aging can check what you qualify for and point you to the right programs, for free. No one will sell your information, and no one will cold-call you.
Source www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medic
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