How to Utilize Medicare Benefits When Terminally Ill

Medicare is a federally funded and operated health insurance program for the elderly (age 65 and over), certain disabled individuals and others meeting the criteria for Medicare eligibility. Original Medicare includes Part A hospital benefits and Part B outpatient medical benefits. Medicare Advantage and Medigap plans are provided by private insurance companies that must follow Medicare guidelines. These plans are designed to supplement or replace original Medicare coverage. Special considerations must be made for terminally ill individuals receiving insurance coverage through Medicare.

Instructions

• 1

  Review the exact terms of your Medicare benefits with respect to treatment of your terminal illness. Medicare will cover hospice care but only under certain conditions. Consider the projected out of pocket cost of your medical treatment after co-payments, co-insurance, deductibles, and non-covered medical services and supplies are paid for.

• 2

  Contact your state Medicaid office to inquire about Medicaid eligibility. Medicaid may cover medical expenses not covered under Medicare. Also, if you enroll in Medicaid and are eligible for the Qualified Medicare Beneficiary (QMB) benefit, Medicaid will pay your Medicare co-payments, deductibles and premiums.

• 3

  Consider enrolling in a Medigap or Medicare Advantage plan if your original Medicare Part A and B benefits are insufficient for covering your medical needs. Medigap is specifically designed for supplementing Part A and B benefits and may cover treatment not covered by your original Medicare benefits.

• 4

  Enroll in a Part D prescription drug program if you require prescription drugs and currently do not have prescription drug coverage. Part D is available for all Medicare eligible individuals and is offered by private insurance companies. Drug coverage varies between providers, so consult with the provider in order to ensure that your prescription drugs will be covered under the Part D plan.