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大巴尔的摩华 人医生协 会 THE CHINESE AMERICAN DOCTORS ASSOCIATION OF BALTIMORE
内容 Content • 大巴尔的摩华 人医生协 会简介 张斗 MD Ph. D • 简介美国的政府医疗 (Medicare and Medicaid)计划及 • • Howard County 最新福利医疗计划 郑雷 MD Ph. D 简介美国政府医疗宣传资料 唐梅 MD 回答问题
大巴尔的摩华 人医生协 会宗旨 • 1) CADAB intends to unite Chinese American • • • doctors for a common purpose of promoting social and professional image of Chinese American doctors. 2) CADAB aims to facilitate friendship and exchange of new medical knowledge among its members through its activities. 3) CADAB shall try to assist member and nonmember Chinese American doctors in need. 4) CADAB shall help to promote the health care awareness in Chinese communities.
简介美国的政府医疗 (Medicare and Medicaid)计划 及Howard County 最新福利医疗计划 大巴尔的摩华人医生协会 (CADAB) April 6, 2008
What Types of Insurance You May Have? • Private Insurance (including visitors’ insurance): e. g. Bluecross/Blueshield • Medicare • Medicaid • Healthy Howard Access Plan (available after July 1, 2008)
What is Medicare? • Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (called “End-Stage Renal. Disease”). • Medicare has – – – Part A (Hospital), Part B (Medical), Part C (Medicare Advantage Plans, like HMOs and PPOs) – Part D (Medicare prescription drug coverage).
Medicare Part A • Cover: inpatient care in hospitals, skilled nursing • • facilities, hospice care, qualified home health care. Do not cover: custodial or long-term care. Cost: No monthly payment for people who or whose spouse paid Medicare taxes while working. If you are 65 or over and have not worked long enough to receive free Medicare Part A, you may be able to buy it.
Medicare Part B • Cover: medical services like doctors’ services, outpatient • • care, some preventive services, and other medical services that Part A doesn’t cover. Do not cover: cosmetic surgery, health care you get while traveling outside of the United States (except inlimited cases), hearing aids, most hearing exams, longterm care (like care in a nursing home), most eyeglasses, and more. Cost: Part B is optional. Ø Most people pay the standard Part B premium ($93. 50 in 2007). Ø You are usually charged a fee for each health care service or supply you get. For some services, you will pay an amount called a deductible before Medicare pays its part. Ø Then, when you get a Medicare-covered medical supply or service, Medicare pays its share, and you pay your share, called the coinsurance or a copayment.
Part C: Medicare Advantage Plans = private insurance-like Medicare • Cover: All Part A and Part B coverage, Part D drug coverage, and extra benefits like those you get from private insurance. • Cost: Monthly premium generally higher than Part B. Costs vary by plan and the services you use.
Medicare Part D: Prescription Drug Coverage • Cover: help lower prescription drug costs • Cost: Part D is optional. Ø Monthly premium varies by plans. Ø Deductibles also vary by plan. No Medicare drug plan may have a deductible more than $265 in 2007. Ø After you have paid the deductible, you pay the same copayment (a set amount) or coinsurance (a percentage of the cost) for any prescription. Ø Some Medicare drug plans have a coverage gap. You reach the coverage gap when you and your Medicare drug plan have spent a certain amount of money for covered drugs. While you are in the coverage gap, you have to pay all costs for your drugs. For plans with a coverage gap, the most you will ever have to pay out-of-pocket before you are out of the coverage gap is $3, 850 (in 2007).
Where can I get more information? • www. medicare. gov • 1 -800 -MEDICARE (1 -800 -633 -4227)
What is Medicaid? • Medicaid (also called Medical Assistance) is a program • that pays the medical bills of people who have low income and cannot afford medical care. Cover: – Health insurance – Long-term care for older (nursing home) – Supplemental coverage for low-income Medicare beneficiaries (e. g. , payment of Medicare premiums, deductibles, and cost sharing). • Medicaid is a joint federal and state program. Each state establishes its own eligibility standards, benefits package, provider requirements, payment rates, and program administration under broad federal guidelines.
You must be…… to get Medicaid • • A resident of Maryland And a U. S. citizen or green carder holder And have lived in the United States as a qualified alien for at least 5 years And one of the followings: Ø At least 65 years old Ø Disabled Ø Blind Ø Under 21 years old Ø Caring for a related child in your home Ø Pregnant Ø The parents of an unmarried child under 21. • And have low income
How much money can I have and be eligible for Medicaid? Family Size 1 2 3 4 5 6 Countable Monthly Income $ 350 $ 392 $ 434 $ 475 $ 521 $ 573 Countable Assets $ 2, 500 $ 3, 000 $ 3, 100 $ 3, 200 $ 3, 300 $ 3, 400 (This is sample information. For updated information, please call Maryland State Department of Health or visit its website. )
Can I have both Medicaid and Medicare at the same time? • Yes if you are qualified for both. • Medicaid program will pay your monthly • • Medicare Part B premiums for you. Medicaid will also pay your Medicare copayments and deductibles. If you are 65 or over and have not worked long enough to receive free Medicare Part A, the Medicaid program will also pay the Medicare Part A premium.
What will I need to do when I apply? • you must go to the Local Department of Social Services in the city or county where you live. • You will be interviewed by an eligibility worker who will ask for information about your income, assets, and private health insurance coverage. You will be asked to prove what you say is true.
Where can I find information for Maryland State Madicaid? • For more information about Medicaid and other Medical Care Programs: (410) 767 -5800 (410) 767 -5503 1 (800) 492 -5231 1 (800) 445 -1159 www. dhmh. state. md. us
What will soon be available to you if you are not qualified for Medicare and you have been legal US resident for less than 5 years (so, not qualified for Medicaid), but have been a resident of Howard County for at least one year on by July 1, 2008?
Healthy Howard Access Plan
To qualify you must • be a legal United States resident • a resident of Howard County for at least one year • make 300 percent of poverty level or below • have been without insurance for one year
Major Coverage and Cost • Primary Care Visits: 6 visits to primary care physician at • • • Chase Brexton. Pay $ 50 -85 monthly fee. Diagnostic Lab & X-ray: 100% provided with referral if performed at HCGH, Quest or by arrangement through Chase Brexton. Outpatient Prescription Drugs: 100% provided when prescriptions are filled at Chase Brexton. $10 fee per prescription, not to exceed $20 per month for all Rx. $30 fee for three-month supply of maintenance drugs. Inpatient care, Anesthesia and Inpatient Surgery: 100% provided for ≤ 300% FPL. Only at HCGH; not provided at other facilities.
Important Information • Enrollment starts on July 1, 2008. The first year will enroll 2, 000 people. • Health care will be available October 1, 2008. • For more information call the information hotline at 410 -313 -HELP (4357) • http: //www. howardcountymd. gov/Health/ Health. Main/Health_HHAccess. Plan. htm
Help with prescriptions • Wal-Mart $4 Prescriptions http: //www. walmart. com/pharmacy • The Bristol-Myers Squibb Patient Assistance Foundation http: //www. bmspaf. org/ • Rx Outreach Patient Assistance Program http: //www. rxoutreach. com/rxoutr/Default 2. aspx • Partnership for Prescription Assistance https: //www. pparx. org/Intro. php
If you are not qualified for any of these health plans and you don’t afford private insurance, …… • Go to emergency rooms if you have urgent illness. You will be treated equally as those who have insurance. • Ask help from patient financial assistants and social workers in the hospital.
Questions? • Please visit or call your health department offices or visit their official websites for updated information.