Medicare
Medicare is a health insurance program for:
People age 65 or older.
People under age 65 with certain disabilities.
People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
Medicare has different parts that help cover specific services:
Medicare Part A (Hospital Insurance) - Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.
Medicare Part B (Medical Insurance) - Part B helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Most people pay a monthly premium for Part B.
Medicare Part D (Prescription Drug Coverage) - Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people pay a monthly premium for Part D.
If you’re a person with Medicare or help a person with Medicare, visit Medicare.gov to find more information about Medicare.
Medicaid
Medicaid is a joint federal and state program that provides comprehensive medical services to eligible low-income individuals, families, and children, including those with disabilities.
In New Mexico, Medicaid (Centennial Care and Turquoise Care) covers a wide range of services, including inpatient and outpatient hospital care, physician services, laboratory and x-ray services, and prescription drugs. Additionally, it offers services like dental, vision, mental health care, long-term care, home health, and transportation.
Mandatory Benefits:
Medicaid is required to offer certain mandatory benefits, such as inpatient and outpatient hospital services, physician services, and laboratory and x-ray services.
Optional Benefits:
States have the flexibility to choose which optional benefits to cover, including prescription drugs, case management, physical therapy, and occupational therapy.
New Mexico Specifics:
New Mexico Medicaid, also known as Centennial Care and soon to be Turquoise Care, covers a broad range of medical services.
The New Mexico Health Care Authority administers the state's Medicaid program.
The New Mexico Health Care Authority's website provides detailed information about the Medicaid program and its services.
Other Important Points:
Medicaid plays a crucial role in ensuring access to healthcare for low-income individuals who may not be able to afford it otherwise.
Medicaid programs can vary across states, so it's important to understand the specific coverage offered in New Mexico.