Medicare/Medicaid

Medicare
Managed by the federal government, Medicare is a publicly funded health insurance program. Medicare supplies medical care and related services to eligible individuals. While Medicare predominately covers people over age 65, it also covers people under age 65 who have been receiving Social Security Disability income for at least 24 months. Medicare helps pay for: inpatient hospital services, skilled nursing care, hospice care, and home healthcare under certain conditions.

Supplemental coverage is at an added cost to you. Coverage which helps pay for medically necessary services and other outpatient care. Outpatient care includes services like laboratory services, medical equipment and some preventive services (like flu shots). Prescription drug coverage is available under Medicare Part D. Prescription drug coverage has an added cost.

Medicare should not be viewed as a free and complete insurance program. Medicare requires co-payments and deductibles. Medicare can be quite expensive. More information about Medicare can be obtained by calling 800-633-4227 or online at http://www.medicare.gov.

Medicaid
Ask your case manager for information about Medicaid. Or 2-1-1 is the referral network of the Texas Health and Human Service Commission.

Medicaid is a jointly funded state-federal health insurance program. Each state has different Medicaid rules. In Texas, it is difficult to qualify for Medicaid. You must have a child under 18 living with you. If you get Temporary Assistance for Needy Families (TANF) or Social Security Income (SSI) you should automatically qualify to receive Medicaid in Texas. If you own property or have a lot of money in the bank, you might not qualify.

Medicaid pays for inpatient hospital services, home healthcare, lab and x-ray services, nursing facility care, outpatient care, family planning/genetics, pregnancy-related services, durable medical equipment, optometry, physical therapy and more. In addition, traditional Medicaid pays for three prescription drugs per month and unlimited prescription drugs if the individual has a Medicaid managed care plan. More information may also be found from Texas Health and Human Services.

Documentation for Medicaid/Medicare
Acceptable documentation to verify Medicaid/Medicare or third-party may include:

Parkland client self-attestation of no change
Parkland self-attestation of change with acceptable documentation from the list below:
- Medicare/Medicaid or other insurance rejection letters;
- Verification of employment, like a payroll stub, copy of payroll check, bank statement showing direct payroll deposit, letter from employer on company letterhead showing wages no greater than six months old; or
- Medifax slips or other automated system (verified monthly)

Acceptable documentation for undocumented and/or homeless clients:

Letterhead from an agency saying the client received services and is undocumented and/or homeless.