Public Benefits That Can Help
Older adults can have a hard time paying for basic necessities like health care and food. This article introduces a variety of federal and state programs that fill this need and describes ways to help your parents apply for benefits.What’s Available
- Social Security, a national program, provides monthly income to people starting at age 62 or those who become disabled and meet strict disability and work eligibility requirements. To receive retirement benefits, you must have paid Social Security retirement taxes for at least 10 years or meet other specific requirements. The amount of your benefit depends on your work history or that of your spouse—whichever is higher—and the age at which you start receiving benefits. The program also provides benefits to family members under certain conditions. To apply, visit your parents’ local Social Security office, call 1-800-772-1213, or go online at www.ssa.gov.
- Medicare is a national health insurance program that helps people age 65 and over, and some younger people with disabilities, pay for their health care. It has several parts: Part A helps pay for hospital care, limited nursing home and home health care, and hospice care; Part B helps pay for doctors’ services, outpatient hospital care, and some other medical services not covered under Part A; Part C (Medicare Advantage) generally covers both Medicare health coverage and prescription drugs through one plan (like an HMO), and Part D helps pay for prescription drugs. At age 65 (or at any age after receiving disability benefits for 24 months), people who get Social Security or Railroad Retirement benefits automatically receive Part A and Part B. Parts B and D are optional. For more information, call Medicare at 1-800-633-4227, or go online at www.medicare.gov.
- Medicare Part D Extra Help Program assists people with Medicare who have limited incomes and assets to pay for most of their Medicare Part D premiums, co-payments, and deductibles. It also provides continuous drug coverage throughout the year. If your parents are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings program, they will automatically get Extra Help with paying for Part D. Otherwise, your parents will need to first apply for Extra Help and then enroll in a private Medicare-approved prescription drug plan. Certain assets such as your house and vehicle do not count against the resource limit. Apply online through AARP’s Benefits QuickLINK tool. You can also apply by calling Social Security at 1-800-772-1213 or using Social Security’s online application at www.ssa.gov/prescriptionhelp/.
- Medicaid, a federal and state health insurance program, assists people with limited resources. Some who may be eligible for Medicaid include disabled or older individuals, and, in some cases, grandparents taking care of grandchildren. Certain people with higher incomes and high medical bills may also qualify. Each state designs and runs its own program, so eligibility criteria and covered services vary. People with Medicare on limited incomes may also qualify for Medicaid, which covers services that Medicare does not. These include long-term nursing home care and, depending on the state, personal or other home care services, eye exams, eyeglasses, and transportation to medical care. (See more below under "Help your parents handle payment issues.") Call your parents' local Department of Social or Human Services. You’ll find it in the special government section, often colored blue, of the phone book. Or, contact the Centers for Medicare and Medicaid Services toll-free at 1-800-638-6833. Or go online at www.cms.hhs.gov/MedicaidEligibility/ to learn more.
- Medicare Savings Programs can help pay your parents’ out-of-pocket Medicare costs if they have limited income and assets. These programs include the Qualified Medicare Beneficiary (QMB), the Specified Low-Income Medicare Beneficiary (SLMB), and the Qualifying Individuals (QI). The QMB program will pay for Medicare premiums, deductibles, and coinsurance for eligible people who qualify for Part A. It will also pay for the annual Part B deductible and the 20 percent coinsurance costs. If your income is too high to qualify for QMB, you may qualify for SLMB or QI, which pay for the Part B monthly premium only. (See the contact information under Medicaid for how to apply or learn more.)
- Food Stamps help people with limited resources buy food. They are free and come in the form of coupons or an electronic benefit card that looks like a credit card. How much someone receives depends on his or her assets, expenses, and how many people live in the household. Residences with a person age 60 and older must adhere to specific rules. To apply, call your parents’ local Department of Social or Human Services, or go online at www.fns.usda.gov/fsp/outreach/map.htm.
- Supplemental Security Income (SSI) pays monthly income benefits to people age 65 and over, as well as to the blind or disabled if they have limited resources. People may receive both Social Security and SSI payments if they meet the requirements. Visit your parents’ local Social Security office, call 1-800-772- 1213, or go online at www.ssa.gov to learn more or apply.
How to Help Here are some steps you may want to take with your parents:
- Talk to your parents about the public benefits they are already receiving and what other types they may qualify for.
- Use the AARP online tool, Benefits QuickLINK, to determine whether your parents qualify for the programs listed, as well as other programs unique to your state. You’ll need to gather information about your parents’ resources before going online. After completing the Benefits QuickLINK survey, print out fact sheets, applications, and websites for public benefits programs in your parents’ home state. If they appear to qualify for a program, find out if they want to apply and help them.
- Help your parents apply for appropriate programs. The first step is to gather proof of your parents’ monthly income and other resources. Your State Health Insurance Assistance Program (SHIP) can aid you or your parents if more in-depth help is needed to apply properly. Find your parents’ SHIP by calling Medicare at 1-800- 633-4227 or go online at www.shiptalk.org. (The SHIP name may be different in your state.)
- Take care of the details. Look over your parents’ papers for important notices about changes in their public benefits (these notices can be difficult to understand). Public programs may require recipients to show each year that they still qualify for the program.
- Help your parents handle payment issues surrounding nursing home care. In general:
- Medicare will cover a maximum of 100 days during a benefit period in a skilled nursing facility (SNF) under certain circumstances. People must need skilled nursing or rehabilitative care after a 3-day related stay in a hospital. The first 20 days in a qualified SNF are fully covered; days 21–100 require a substantial co-payment by the resident. Medicare will also pay for home health care visits in some situations and 80 percent of the costs for related medical equipment.
- Medicaid covers long-term care services in a nursing home or, depending on the state, in the community for functionally and financially limited people. Each state has different rules for Medicaid. Most states will automatically cover long-term care for people with SSI under Medicaid provided they meet the state’s functional eligibility criteria. Some offer programs for the medically needy—people whose income exceeds Medicaid’s limit but suffer large medical expenses such as nursing home bills. Some states have optional programs for individuals whose income surpasses the SSI limit.
If your parents receive nursing home care under Medicaid, they must turn over most of that income to the nursing home. Special provisions exist, however, for a portion of the income to remain with the at-home spouse if only one parent lives in a nursing home. Your parents will be ineligible for Medicaid for a period of time if they try to qualify by giving away property or savings to family members or selling assets for less than they are worth. Finally, some nursing homes do not accept individuals whose bills will be paid through Medicaid.
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