The Definitive Guide to Medicare Rights

As we approach the holidays, many of us are starting to think about what gifts to buy for our loved ones. One thing that is important to consider is how Medicare will affect your loved one’s quality of life. Many people assume incorrectly that Medicare covers all medical expenses and all medications, but this is not the case. There are many things that Medicare does not cover, and understanding what you can expect from the program is important for your loved one’s future. You don’t have to be a Medicare expert to be informed.

Myth: You automatically get medicare when you turn 65 years old. False! There are two sets of requirements in order to qualify for Medicare coverage- criteria based on age or disability status. The qualification process varies depending with whether an applicant has a medical condition that meets Social Security’s definition of “disability”. One way to determine if someone qualifies for disabled status under social security law is by answering the following questions:

Is the person unable to do any type of substantial gainful work because of a medically determinable impairment?

Does the applicant have an extreme limitation in one or more activities, including walking and climbing stairs?

If you answer “yes” to those two questions, then your loved ones may be eligible for Medicare. Most people who are 65 years old meet these requirements as well. If not, there are other options they can explore that might be available to them through their state Medicaid program.

Myth: All medicines are covered by medicare False! As with many things associated with health care coverage, it’s important to know what is and isn’t covered by Medicare before making assumptions about taking advantage of this great benefit. Sadly, the majority of medications are not covered by Medicare. This includes most breathing equipment and oxygen tanks, insulin pumps for diabetics, diapers for those with incontinence problems or who have had an ileostomy surgery in order to treat ulcerative colitis.

Myth: You can’t get medicare if you’ve been incarcerated False! If a person is 65 years old or older as well as disabled under Social Security law and has served time in prison after December 31, 1997 but before July 16 2006 they may be eligible for disability benefits from Social Security (even while still serving their sentence). For people whose last incarceration was on or after July 16th 2006 it’s unlikely they would qualify because there is no period of post-incarceration recovery time.