Financial Assistance

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Medicare

Medicare is our only national health insurance program, serving over 44 million Americans. The program provides health benefits to almost 7 million people younger than age 65 who have a disability or chronic condition. Individuals may be entitled to Medicare if they qualify for Social Security Disability Insurance (SSDI) benefits, or have either End Stage Renal Disease or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.

The Center for Infants and Children with Special Needs at Cincinnati Children's Hospital Medical Center provides information to help families and health care providers identify sources of financial assistance.

Medicare Overview | Dual Medicaid / Medicare Coverage

Medicare Overview

Medicare provides certain adults with disabilities with publicly funded health insurance. Because it is a federally funded health insurance program, Medicare eligibility is the same in each state. You must qualify for and receive Social Security Disability Insurance (SSDI) monthly income benefits to be eligible for Medicare. SSDI benefits are based on work credits earned through Social Security. In addition, certain dependent adult children of parents who receive Medicare are also eligible for Medicare if the adult child developed a permanent and severe disability before age 22.

You will be automatically enrolled in Medicare after you get SSDI benefits for 24 months. Exceptions are made for those with end stage renal disease or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease.

Medicare.gov is the official site for Medicare information and resources.
Medicare Eligibility Tool provides information on enrollment and eligibility.
Navigating Medicare and Medicaid, Kaiser Family Foundation
Talking About Medicare: Your Guide to Understanding the Program, Kaiser Family Foundation

Medicare's prescription drug coverage, sometimes called Medicare Part D, began January 1, 2006. You have a choice of prescription drug insurance plans which are available through private insurance companies. Participation is income driven, therefore you will pay a monthly insurance premium plus a portion of the prescription cost through a copayment. Medicare prescription insurance plans are open to everyone who is eligible for Medicare.

Medicare provides an overview of the prescription drug plan.
Medicare and You is a booklet that has information on the changes in prescription drug coverage.
Medicare Prescription Drug Plan Finder will help you identify plans through a personalized search or through a search by state.

Dual Medicare / Medicaid Coverage

Medicaid assistance may also be availablefor people with disabilities if they meet Medicaid's low income guidelines. Medicaid can play a critical role filling in Medicare’s gaps in coverage. Assistance ranges from paying for Medicare's premiums and cost-sharing, to coverage of benefits not offered under Medicare, including hearing, vision, dental and long term care. An individual may want to have Medicare in addition to Medicaid because the combination can provide better access to care. Because Medicaid reimbursement is lower than Medicare, many physicians will not accept Medicaid patients. However, almost all physicians accept Medicare.