Medicare, Medicaid, and Long-Term Care are three separate government programs that can provide health care coverage for eligible individuals in Colorado. Here’s a brief overview of each program, including enrollment information, what they cover, and what they don’t.
Medicare:
Medicare is a federal health insurance program that covers people aged 65 or older, as well as younger people with disabilities or certain medical conditions. It has several parts, including:
- Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care.
- Part B (Medical Insurance): Covers doctor visits, outpatient services, and preventive care.
- Part C (Medicare Advantage): Allows private insurance companies to offer Medicare benefits, often including prescription drug coverage and additional services.
- Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs.
Enrollment: If you are turning 65, you can enroll in Medicare during your Initial Enrollment Period (IEP), which begins three months before your 65th birthday and ends three months after. If you miss your IEP, you can enroll during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year.
What Medicare doesn’t cover: Medicare does not cover all health care costs. For example, it does not cover long-term care (see below), most dental care, eye exams related to prescribing glasses, hearing aids, or routine foot care.
Medicaid:
Medicaid is a joint federal-state program that provides health care coverage for people with low income and limited resources. Eligibility and benefits vary by state, but in general, Medicaid covers a wide range of medical services, including doctor visits, hospital stays, prescription drugs, and long-term care.
Enrollment: To enroll in Medicaid in Colorado, you can apply online at the Colorado PEAK website or by calling the Colorado Medicaid Customer Contact Center.
What Medicaid doesn’t cover: Medicaid does not cover all health care costs, and benefits can vary by state. In general, Medicaid does not cover services that are not medically necessary, such as cosmetic surgery or experimental treatments.
Long-Term Care:
Long-term care refers to a range of services and supports for people who need assistance with activities of daily living (such as bathing, dressing, and eating) due to a chronic illness, disability, or aging. Long-term care can be provided in a variety of settings, including nursing homes, assisted living facilities, and in the home.
Enrollment:
There is no enrollment process for long-term care. Instead, individuals must meet certain eligibility criteria (such as requiring assistance with activities of daily living) and have the financial resources to pay for care.
Exclusions:
Long-term care can be expensive, and most private health insurance plans do not cover it. Medicare does not cover long-term care (except for limited periods of time under certain circumstances), and Medicaid only covers long-term care for individuals who meet certain income and asset requirements.
