Marci's Medicare Answers

August 2010

Dear Marci,

I’m planning to get a Hepatitis B shot. Will Medicare cover it?

—Gary

Dear Gary,

Your Medicare health coverage (Part B) will cover vaccines to prevent Hepatitis B only if you are at medium to high risk for hepatitis B (you have kidney failure, hemophilia or travel to countries with high rates of the disease). In 2010, if you are at medium to high risk, Medicare will cover 80 percent of the cost of your hepatitis B vaccine after you pay your annual Part B deductible.

—Marci


Dear Marci,

I just received a Medicare Summary Notice in the mail, and I’m not sure what it is. Is it a bill?

—Ramesh

Dear Ramesh,

When Original Medicare processes a claim for health care services you received, the claim is detailed in a Medicare Summary Notice (MSN). The MSN is a summary of claims for health care services Medicare processed for you during the previous three months. The MSN is not a bill.
MSNs are mailed four times a year and contain information about submitted charges, the amount that Medicare paid, and the amount you are responsible for.
The most important fields on your MSN explain:

  • The total amount your doctor or other provider may bill you.
  • Non-covered charges, if any.

Try to save your MSNs for about seven years. You might need them in the future to prove that payment was made if a provider sends you a bill, or that services were received if you claimed a medical deduction on your taxes. If you have lost your MSN or you need a duplicate copy, call 800-MEDICARE. You will be redirected to the Medicare carrier who originally issued the MSN and can send you a copy.

—Marci

Dear Marci,

If I have Medicare, am I allowed to enroll in Medicaid programs as well?

—Loretta

Dear Loretta,

Yes. Medicaid programs can help pay for Medicare’s costs and for services that Medicare does not cover. If you are eligible for Medicare and have low income, you may qualify for help from certain Medicaid programs in your state. In general, your state will have more than one program that can help people who are eligible for Medicare. Whether you qualify for a Medicaid program will depend on:

  • your income (money you take in, for example, from Social Security payments or wages that you earn);
  • your assets (resources such as checking accounts, stocks and some property); and
  • if you need long-term care, whether you meet your state’s “functional eligibility” or “level-of-care” criteria–standards for assessing your need for help with activities of daily living (for example, toileting, bathing, dressing) and your need for nursing care. Each state sets its own standards.

 In general, people with Medicare who have low income may qualify for one of the following:

  1. Medicaid for people who are “over 65, blind or have a disability” and do NOT need long-term care
  2. Nursing Facility Medicaid
  3. Medicaid Waiver Programs for long-term care in your home or community

To find out what Medicaid programs exist in your state, contact your State Health Insurance Assistance Program (www.shiptalk.org) or local Medicaid office.

—Marci

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Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare. To subscribe to “Dear Marci,” MRC’s free educational e-newsletter, click here.

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