MEDICARE & MEDICAID

YOUR DOWNERS GROVE DISABILITY LAWYER EXPLAINS MEDICARE AND MEDICAID
health-caredoctor explains health care coverageEveryone deserves quality health care and access to doctors, hospitals and prescription drug coverage. If you have applied for Social Security Disability or SSI disability benefits, or are already receiving benefits, you likely qualify for either Medicare or Medicaid. You must apply for Medicaid through your county’s Office for Public Aid. You become eligible for Medicare 24 months after the start date of your disability benefits. You must apply to these programs separately from Social Security benefits, but the eligibility requirements overlap. Downers Grove Social Security Attorney Mary L. Collins assists clients denied Medicare and Medicaid coverage so that they receive necessary health care and medical treatments.

The Differences Between Medicare and Medicaid
Medicare is health insurance that is available to most people at age 65 and to disabled individuals who are eligible to receive Social Security benefits or those who have permanent kidney failure at any age. It is a federal program available without regard to income, and the government typically offers it to those receiving Social Security Disability benefits.

Medicare has four types of coverage; you may be eligible for all or partial coverage:

A. Hospital insurance
B. Medical insurance
C. Medicare Advantage (combined A and B coverage)
D. Prescription drug coverage
Medicaid, unlike Medicare, is income-based health insurance available to people whose income falls below the standard as dictated by the government. Medicaid is regulated by the states and is composed of a number of different health care plans. In Illinois, the Department of Healthcare and Family Services (DHS) runs the programs. You can apply for benefits at the Public Aid office in your county.

Qualifying for Medicare or Medicaid
To be eligible for Medicare, you must meet the following requirements:

  • You or your spouse worked for at least 10 years in Medicare-covered employment, and
  • You are 65 years or older, or have a disability or kidney failure, and
  • You are a citizen or permanent resident of the United States

If you are eligible for Medicare, Part A, does not require payment of a premium if you are on benefits. Part B and Part D require premium payments.

Eligibility for Medicaid programs run by the State of Illinois DHS will depend on your specific situation and needs. Some people may quality for full coverage, while others may only receive temporary or limited coverage. In general, the State of Illinois offers Medicaid to individuals and families at or below the federal poverty level. You will be eligible for Medicaid if you are low-income and:

  • You are disabled, as determined by the Social Security Administration
  • You are blind
  • You are 65 or older
  • You have a dependent child or children under age 19
  • You are pregnant

If you qualify for SSDI or SSI benefits, you are likely also eligible for comprehensive or partial health insurance through the Medicare or Medicaid programs. Contact Downers Grove disability lawyer Mary L. Collins if you feel the government should not have denied you necessary health care coverage – call today to talk to Mary about Medicaid, Social Security and Medicare.

County and Local Programs
If you are not insured and have not qualified for benefits under one of these programs, it can be very difficult to obtain the care you need. It also may affect your application for disability benefits, because you need medical evidence to prove your claim. If you call Mary L. Collins in Downers Grove, we will try to give you information on local health care facilities that are available through the county or township. Our Downers Grove office tries to update lists for all of our surrounding counties: Kane, Will, DuPage and Cook.