Resources

Medicare is available if you’re at least 65 years old or have some disability, such as amyotrophic lateral sclerosis (ALS), that qualifies you for Social Security Disability Income (SSDI) benefits. To receive premium-free Part A coverage, you must have worked and paid Medicare taxes for a minimum number of quarters. You must also be a U.S. citizen or lawful permanent resident.

Medicaid eligibility requirements can be confusing, especially for applicants under 65 who get Medicare coverage for a qualifying disability. Area Agencies on Aging have trained counselors on hand to answer questions about Medicare and help current Medicare beneficiaries determine if they might be dually eligible. AAA counselors can also help you determine if you’re eligible for the QMB, SLMB, QI, or QDWI programs.

Some communities have geriatric care managers available to assist. A geriatric care manager is a registered nurse or social worker who has been trained to help older adults access health and social services. In addition, elder care attorneys, State Health Insurance Assistance Program counselors, and commission-based Medicaid planners are also good resources for information on Medicaid eligibility and benefits.

As long as they cover mandatory benefits required by CMS, states can implement cost-sharing arrangements as part of their Medicaid plans. CMS caps out-of-pocket costs, but state Medicaid programs are also allowed to charge a premium for enrollees in the following groups:

To apply for Medicare, contact your social security office or visit ssa.gov. To apply for Medicaid, contact your local Medicaid office to ask questions about program requirements and the application process.