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Malti Patel

Q. How do I apply for Medicare?

A. Most people qualify for Medicare when they turn 65. You qualify for it if you're eligible for Social Security or Railroad Retirement benefits. Or you may qualify on a spouse's (including divorced spouse's) record. Others qualify because they are government employees not covered by Social Security who paid the Medicare part of the Social Security tax.

In addition, if you've been getting Social Security disability benefits for 24 months or get Social Security disability benefits and have amyotrophic lateral sclerosis (Lou Gehrig's disease), you'll qualify for Medicare. You also may qualify if you have permanent kidney failure and receive maintenance dialysis or a kidney transplant.

If you are already getting Social Security benefits, you'll automatically be enrolled in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will be contacted by mail a few months before you become eligible and given all the information you need. If you are not already getting benefits when you turn 65, you should call or visit a Social Security office three months prior to your birthday to sign up for Medicare.

You should do this even if you plan to continue working or do not think you have enough work credit under Social Security, because Medicare enrollment period rules are strict and there is penalty clause for not applying/informing Medicare.

Q. What are the differences between Medicare Parts A, B, C and D?

A. There are four parts to Medicare: Medicare Part A, Hospital Insurance; Medicare Part B, Medical Insurance; Medicare Part C (Medicare Advantage), which was formerly known as "Medicare + Choice" and the new Medicare Part D, prescription drug coverage. Generally, people who are over age 65 and getting Social Security automatically qualify for Medicare Parts A and B.

So do people who have been getting disability benefits for two years, people who have amyotrophic lateral sclerosis (Lou Gehrig's disease) and receive disability benefits, and people who have permanent kidney failure and receive maintenance dialysis or a kidney transplant.

Part A is paid for by a portion of Social Security tax. It helps pay for inpatient hospital care, skilled nursing care, hospice care and other services.

Part B is paid for by the monthly premiums of people enrolled and by general funds from the U.S. Treasury. It helps pay for doctors' fees, outpatient hospital visits, and other medical services and supplies that are not covered by Part A.

Part C (Medicare Advantage) plans allow you to choose to receive all of your health care services through a provider organization. These plans may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C.

Part D (prescription drug coverage) is voluntary and the costs are paid for by the monthly premiums of enrollees and Medicare. Unlike Part B in which you are automatically enrolled and must opt out if you do not want it, with Part D you have to opt in by filling out a form and enrolling in an approved plan.

Q. I'll be 65 years old soon. When should I sign up for Medicare?

A. It is advisable to file for Medicare benefits three months before age 65. Remember, Medicare benefits can begin no earlier than age 65. If you are already receiving Social Security, you will automatically be enrolled in Medicare Parts A and B without an additional application. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will receive a Medicare card about two months before age 65.

If you would like to file for Medicare only, call 1-800-772-1213.

Q. How do I apply for Medicaid?

A. Medicaid is a medical assistance program that is partially funded by the federal government but run by each state. Medicaid pays for basic medical care for people and families with low incomes and resources. People who are blind or disabled, age 65 or older, children, or members of families with dependent children may be eligible. Using broad federal guidelines, each state runs its own Medicaid program. The state decides who is eligible and the amount of medical care and services it will cover.

These questions and answers are courtesy of Malti Patel, 1607 Wood Creek Lane, Allen, Texas-75002. Patel published a book "Lifting the Mists: A simple guide to a complex welfare system for elderly immigrants and their families." Contact Patel at to order the book.

Ramesh Parekh

What is "Long-Term Care?"

As we grow older, there are greater possibilities that we may not be able to perform our routine tasks such as bathing, dressing, eating, etc. Such needs generally arise because of a prolonged physical illness, a disability or a cognitive impairment (such as Alzheimer's disease). Long Term Care (LTC) is different from traditional medical care. LTC includes help with activities of daily living, home health care, nursing home care or care in an assisted living facility. The type of care can be either skilled or custodial care.

Cost of LTC

LTC costs can be high. The costs vary depending upon the parts of the country and the type of care needed. According to Genworth 2009 Cost of Care Survey, a sample of Median LTC costs in Tampa-St. Petersburg Area:

Nursing home private room - Annual ----- $82,125

Assisted living facility private one bedroom - Annual ----- $24,000

Home Health Aid Service - hourly rate ----- $17-$32

Who bears the burden of long-term care?

There are basically three sources of funds available for LTC:

1. Self-insurance - own or family and friends funds

2. Public program - Medicaid if qualified for the poverty level prescribed by the state.

3. Long-term care insurance

Reasons people buy LTC insurance:

1. Financial protection for retirement

2. Protecting families

3. Wealth and estate protection

4. Financial independence

5. Peace of mind

Recognizing the seriousness of the long-term care costs on an aging society like ours, Congress provided specific tax benefit for long-term care policy premiums. Many states, including Florida, have instituted state LTC Partnership Programs to encourage the public to get LTC coverage.

Long-term care insurance is a part of an individual's financial planning and risk management. You should consult a financial adviser for your specific needs and financial suitability.

Florida Resources for more information:

Florida Department of Elder Affairs - Tallahassee (850) 414-2000

National Association of Insurance Commissioners, Kansas City, Mont.; (816) 842-3600;

Ramesh Parekh, CPA, can be reached at (727) 461-9770 or e-mail or

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