DuPage Center for Independent Living: Medicare/Medicaid Services

Medicare is a federal health insurance program for people who are 65 or older and for people with disabilities under the age of 65. Medicare has four parts: Hospital insurance (Part A), Medical Insurance (Part B), Medicare Advantage (Part C), and the Medicare Prescription Drug Benefit (Part D).

An individual aged 65 years or older and eligible for benefits under Social Security or the Railroad Retirement System, or a federal, state or local government employee insured on his/her own record or that of a spouse.
An individual who has been receiving disability benefits under Social Security or the Railroad Retirement System for 24 months or more.
Persons of any age who are receiving regular dialysis or have received a kidney transplant due to kidney failure.
Persons of any age who have been diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease.
A person 65 or over who is not eligible for Social Security benefits may purchase Medicare coverage.

For those who are eligible, there are no cost for Part A. There are additional deductibles and co-payment for medical services. The cost for Part C varies from plan to plan.

Medicaid is a state managed medical assistance program that is funded by both state and federal monies. Medicaid can provide eligible low-income families and seniors with coverage for a variety of medical services.

You are a U.S. citizen or meet certain non-citizen requirements.
You are an Illinois resident; and
You meet the following program requirements.

Income and assets

All your earned income, and unearned income are reviewed when you apply for medical benefits. If you are age 65 or older or are disabled or are blind, your assets will also be reviewed. Earned income is wages from your job or profits from your business. Unearned income includes money from Social Security and any other money you receive. Assets are the things you own.

If you have too much income or assets to be eligible for medical benefits, but you meet all other eligibility requirements, DHS may put you in the medical benefits spend down program. If you participate in the spend down program, payment will be made for some of your medical care each month after you show your caseworker medical bills that equal a certain amount. This amount is called the spend down amount.
You will receive a notice telling you the amount of your spend down.

Health insurance

You must also give any information you have about your health insurance.

If you are getting cash from the federal Supplemental Security Income (SSI) program or have applied for and are approved to receive SSI, Social Security disability or Railroad disability benefits, this will be accepted to prove that you are aged, blind or disabled. If you do not receive these benefits and do not wish to apply for them, then your age, blindness, disability or incapacity will be evaluated.

If your application for medical benefits is turned down, you can fill out an appeal form or call 1-800-435-0774; TTY: 1-877-734-7429 and ask for a special meeting called a hearing. The call is free. At the hearing, you can explain why you think your application should be approved.

For more information about your right to appeal and receive a fair hearing, ask your caseworker or call 1-800-435-0774; TTY: 1-877-734-7429. The call is free.

Medicare
Medicaid
Medicare Supplement Insurance
Medicare Advantage Plans, HMOs, PPOs, and PFFs
Prescription Drug Coverage through Medicare and other sources
Long-term Care Insurance
Medicare Claims and Appeals
Medicare Beneficiary Rights and Guarantees

Need help understanding your Medicare & Medicaid coverage?
Schedule an appointment to see Don Davia, Benefits Coordinator!!