Health Care Plan Choices

# MEDICARE: A federal health insurance program for people age 65 and older and certain people under 65 with disabilities. Under this plan, broken into Part A and Part B, a client may go to any doctor, specialist, hospital or other facility that accepts Medicare. Not covered: Prescription drugs, long-term custodial care.

# MEDICAID: A program sponsored by the federal government and administered by states, which each budget their own Medicaid spending and receive federal funds based on a matching formula. The program is intended to provide health care and health-related services to low-income individuals. States set eligibility guidelines based on certain income levels, disabilities and other personal needs.

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MEDICARE ADVANTAGE: A health care plan offered by private companies under contract with Medicare. They are also called Medicare+Choice or Medicare Part C plans. You must be enrolled in Medicare Part A or Part B plans to participate in Medicare Advantage. Participation is voluntary. Services are often limited to the plan's provider "network." Most Medicare Advantage plans offer more benefits than standard Medicare, such as routine checkups, dental coverage and hearing tests - but often do not cover treatments outside the provider network. Medicare Advantage plans usually charge a monthly fee. On average, subsidies for Medicare Advantage plans cost the government about 20 percent more than traditional Medicare.

# MEDICARE ADVANTAGE SPECIAL NEEDS PLANS (SNPs): Created to encourage greater access to Medicare-managed care for certain special needs populations: the institutionalized, persons dually eligible for Medicare and Medicaid, and the chronically ill. Some see SNPs as an opportunity to integrate acute and long-term health care as well as Medicare and Medicaid financing for potential cost savings and more comprehensive services. Others are less certain about the benefits of or potential for full integration. Connecticut's Medicare Advantage proposal deals specifically with "dual eligible" individuals with special health needs, many of whom have never dealt with private HMOs to receive their Medicare services.

source:www.courant.com