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Medicare & Medicaid

There are two medical programs run by the U.S. government. One, Medicare, is paid for contributions from workers' paychecks. The cost of the means-tested program for low-income folks, Medicaid, is split between the federal and state governments, though their general funds.  

Medicare pays for most of the cost of hospitalization, rehabilitation, doctors' visits, labratory expenses, prescription drugs, and much other medical care for older and disabled Americans, but it still leaves almost half of all medical costs unpaid. Most people need a medigap insurance policy or Medicare managed care plan (Medicare Part C) to cover the gaps in Medicare.

For those with low income and assets, Medicaid can pay for medical expenses for who don't qualify for Medicare—or can cover the gaps in Medicare for those who do.  

Medicare and Medicaid coverage explained.

Many federal and state government benefits are tied to the federal poverty level (FPL), or percentages of the FPL.

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Medicaid is a program that provides very low-cost or free health care to some adults and children with limited incomes.

In North Carolina, Medicaid is a common funding source for long-term care, particularly when people have already used up all of their own assets to pay for private care.

Many individuals who apply for Medicaid find that they have too many assets to qualify.

If you applied for Medicaid and your state Medicaid agency denied your application, then you can appeal the denial.

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A growing number of patients recovering from surgery or a major illness are referred by their doctors to skilled nursing facilities.

The QMB, SLMB, and QI programs help pay Medicare premiums, deductibles, and co-pays. Learn how to qualify.

The categories of medical treatment and services listed below are not covered by Medicare.

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