Day 6 & 7Public Benefits

Review

Medicare For people 65+ and under 65 with a disability 4 parts of Medicare

• Part A: Hospital Insurance• Part B: Medical Insurance• Part C: Medicare Advantage Plans• Part D: Prescription Drug Coverage

Part A & B called Original Medicare• Automatic enrollment if getting SS benefits, must enroll if not• Premiums always for Part B, only for A if not enough credits• Not comprehensive coverage, has coverage gaps• Out-of-pocket costs for A & B change yearly- see chart

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Three Enrollment Periods Initial Enrollment Period (IEP): 7 months surrounding 65th

birthday month (month earlier if birthday on 1st of month)• Date of enrollment determines effective date of Medicare

Special Enrollment Period (SEP): 8 months following loss of coverage from “active” employment

General Enrollment Period (GEP): Jan 1st – March 31st of each year • July 1st effective date

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Delaying Part B Enrollment Individuals may choose to have just Medicare Part A while they are

ACTIVELY working or are covered under a spouse who is ACTIVELY working

Once ACTIVE employment coverage has ended, must take Part B coverage within 8 months to avoid a penalty (there is no 8 month period for retiree coverage)

If the employer has <20 employees or <100 employees if the beneficiary has a disability, then the individual may need Part B because Medicare should pay first and Employer Group Health Plan (EGHP) second• Beneficiaries should confirm with their employer if Part B is needed

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Late Enrollment Penalty Penalty for Part A: Capped at 10% of premium and goes away

after penalized for twice the length of time the person delayed enrollment• Only for voluntary enrollees (paying for A) who don’t enroll in

Part A when initially eligible

Penalty for Part B: 10% of premium for each full 12 month period the individual delayed enrollment

• Penalty for Part B not capped and is a lifetime penalty except: Under 65 beneficiaries with a penalty will have the

penalty removed and will have a “clean slate” when they turn 65

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Medicare Pays for reasonable and medically necessary services There are coverage gaps in Medicare including: Part A in-patient hospital deductible Part A daily co-payment for in-patient hospital days 61-90 Part A daily co-payment for in-patient hospital days 91-150 Part A daily co-payment for SNF days 21-100 Part B annual deductible Part B co-insurance (usually 20%) First three pints of blood Coverage outside the United States

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Two Options For Supplementing Medicare

Step 1: Decide how you want to get your coverage

PART AHospital

Insurance

PART BMedical

Insurance

PART CCombines Part A, Part B

and usually Part D

ORIGINAL MEDICARE MEDICARE ADVANTAGE PLAN

OR

PART D Stand Alone PDP

PART DIncluded in Part C

Step 3: Decide if you need to add supplemental medical coverage

MEDIGAPSupplement Core or Supplement 1 plan

ENDIf you join a Medicare Advantage

Plan with drug coverage (MAPD), you cannot join another drug plan and

you don’t need and cannot be sold a Medigap policy

Step 2: Decide if you need a Prescription Drug Plan

&

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Medigap vs.Medicare Advantage

Original Medicare + Medigap Supplement 1 Medicare Advantage Plan

Higher premiums but no co-pays Generally lower premiums but

has co-pays Freedom to choose doctors May be restricted to network

No referrals necessary May need referrals for

specialists Some routine services not

covered (vision, hearing) May include extra benefits

(vision, hearing, fitness)

Covered anywhere in US Emergency services ONLY

outside service area

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Part D Must have Part A and/or Part B to be eligible

2 ways to get prescription coverage:1. Medicare Prescription Drug Plans (PDPs); also known as

stand alone plans2. Medicare Advantage (Part C) Plans with drug coverage

Part D is voluntary, but eligible beneficiaries who do not enroll may be subject to a penalty• Must have “creditable coverage” to avoid penalty

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Part D Enrollment Initial: Mimics Part B 7 month period Open: Oct 15th – Dec 7th, coverage effective Jan 1st Special: Refer to SEP chart for applicable situations MADP: Jan 1st – Feb 14th Late: Penalty is 1% of the national base beneficiary premium for EACH

MONTH the beneficiary:• Did not enroll in a Medicare PDP when they were first eligible AND:

Had no prescription drug coverage OR Had coverage that was not considered “creditable OR Had a lapse in creditable coverage of 2 full months (63 days)

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Part D Formulary The prescription benefit includes a list of “covered drugs” and this

list is called the “formulary”

If the insurer is very selective about which drugs are to be covered, then it is sometimes referred to as a “closed formulary”. If the formulary is open to all drugs but places drugs into different cost sharing categories or “tiers”, it is referred to as an “open formulary”

Each plan must meet formulary standards. The formulary must include and cover certain drugs or certain classes of drugs. Medicare has established a category of excluded drugs

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Extra Help Federal assistance program to help low-income and low-asset Medicare

beneficiaries with costs related to Medicare Part D

Extra Help subsidizes:• Premiums• Deductibles• Copayments• Coverage Gap “Donut Hole” • Late Enrollment Penalty• Does NOT subsidize non-formulary or excluded medications

Apply through Social Security Administration

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Prescription Advantage Massachusetts’ State Pharmacy Assistance Program (SPAP)

Provides secondary coverage for those with Medicare or other “creditable” drug coverage (i.e. retiree plan)

Provides primary prescription coverage for those who don’t qualify for Medicare

Benefits are based on a sliding income scale only– no asset limit!

Level of assistance provided is determined by gross income

Different income limits for under 65 and 65 and over

Members are provided a SEP (one extra time each year outside of open enrollment to enroll or switch plans)

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Public Benefits

SHINE and Public Benefits

SHINE counselors screen individuals for potential eligibility for health/prescription-related public benefit programs, provide education about the benefits, and may assist in the application process

Counselors do not guarantee that an individual will be eligible for these programs; this decision can only be made by the benefit program

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Supplemental Security Income (SSI)

Federal income supplement program funded by general tax revenues to help aged, blind, and people with disabilities who have little or no income

Needs based program Provides cash to meet basic needs for food, clothing, & shelter Different income supplements for various living arrangements Apply through Social Security office Automatic enrollment into MassHealth

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MassHealthMedicaid= National public health insurance program

MassHealth= Massachusetts Medicaid program

Public health insurance program for low- to medium-income residents of Massachusetts

Administered by state Medicaid agencies within broad parameters established by federal regulations

Overseen by the Centers for Medicare & Medicaid Services (CMS)

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SHINE and MassHealth

SHINE focus is on MassHealth ONLY AS IT RELATES TO MEDICARE BENEFICIARIES

Benefit programs and eligibility criteria may differ for individuals who are not entitled to Medicare

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Dual-Eligible

Medicare beneficiaries who are enrolled in MassHealth Standard are referred to as dual-eligible

Dual-eligibles can receive assistance paying for Medicare premiums, deductibles, co-insurance, and co-pays

Dual-eligibles receive the many MassHealth covered services that Medicare beneficiaries typically do not receive

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Dual-Eligible's and Part D Dual-eligibles MUST enroll into a Medicare Part D plan

If beneficiary does not enroll into a plan within 60 days, they will be auto-assigned to a plan

Best to avoid this: Auto-assigned plan may not be lowest cost and formulary may not list all of beneficiaries drugs

Dual-eligibles automatically “deemed eligible” for Full Extra Help, regardless of income and assets

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Dual-eligible's and Part D, cont. MassHealth will cover a drug that Medicare does not pay for

• Will NOT cover a drug that Medicare does pay for but is not listed on the beneficiaries plan formulary

MassHealth is always the payer of last resort• Will NOT provide primary prescription drug coverage for dual-

eligible's Dual-eligibles not yet enrolled into Part D may receive their

prescription drugs at the Extra Help co-pay amounts by using the Limited Income Newly Eligible Transition Program (LINET)

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Limited Income Newly Eligible Transition Program (LINET)

Provides immediate prescription drug coverage for people with Medicare who are at the pharmacy counter and qualify for Extra Help, but aren’t yet enrolled in a Medicare drug plan• Also covers prescriptions that eligible people filled within the last 30

days

Covers all Part D covered drugs; No prior authorization or network pharmacy restrictions during the time period covered by this program

Will be charged the reduced co-payment based on the level of Extra Help they are eligible for

Program administered by Humana

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MassHealth Standard Eligibility Determining eligibility for MassHealth is a complex process SHINE may screen for potential eligibility, educate clients about

MassHealth benefits, assist in the application process• Should not guarantee eligibility; this decision should be left to

MassHealth Must be a Massachusetts resident

• Defined as someone living in Massachusetts and intends to stay Different eligibility requirements for applicants age 65 and older and

those under age 65

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Financial Eligibility 65+ For married couples living together, eligibility usually based on the

combined income and assets of both members of the couple Must meet both income and asset guidelines in order to qualify for

MassHealth Standard• Income eligibility: Countable income at or below 100% of the Federal

Poverty Level (FPL)

• Asset eligibility: $2,000 or less in countable assets ($3,000 for a couple) To determine income:• Take gross countable income and subtract 2 deductions: Unearned

income disregard and Earned income disregard

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Income Disregards Unearned income disregard is a $20 deduction from the household’s

total countable unearned income. Married couples receive only one $20 deduction from their combined countable income

Earned income disregard is calculated by subtracting $65 from the individual’s gross earned income, and dividing the remainder by 2. Married couples in which both people are working will both receive separate earned income disregards

All disregards already calculated in the Pink Sheet (Eligibility Guidelines for Health/Prescription-Related Public Benefits Programs)

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Income:Countable VS. Non-Countable

Countable Income•Social Security benefits•Railroad Retirement

benefits•Pensions•Earned income•Rental income•Federal veteran pensions

& disability compensation• Interest income

Non-countable Income

• Cash assistance from SSI or the Department of Transitional Assistance (DTA)• Income-in-kind (e.g., gifts)• Income from a reverse

mortgage• Veterans’ Aid & Attendance

benefits• Chapter 115 benefits for

veterans27

Assets:Countable VS. Non-CountableCountable Assets

• Bank accounts• Whole life insurance

policies, when total face value of all policies is over $1,500• Individual retirement

accounts (IRA)• Stocks and bonds• Second homes/cars• RVs/Boats

Non-countable Assets

• Primary residence and 1 car• Personal belongings & home

furnishings• Term life insurance policies• Whole life insurance policies

with total face value $1,500 or less

• Burial plot • $1,500 burial-only account• Irrevocable burial contract 28

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Financial Eligibility Under Age 65 NO asset limits Income limit is 133% of the FPL Earned income disregard and unearned income disregard not

used Modified Adjusted Gross Income (MAGI) used instead of gross

income• Applicant receives an income deduction equivalent to 5% of the FPL

MAGI already calculated in the Pink sheet

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Examples of MassHealth Covered Services

• In/Out-patient hospital services• Emergency hospital services• Skilled nursing facility• Home health care • Case management services• Clinic services• Diagnostic services• Dental services • Programs for all-inclusive care for

the elderly (PACE)• Personal care services (PCA)

• Hospice care• Medical Transportation• Occupational therapy • Optometrist services• Physical therapy• Podiatrist services• Preventative services• Private duty nursing• Prosthetic/orthotic devices• Psychologist services• Rehabilitative services• Respite care

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Applying For MassHealth Best for the individual, spouse, family member to complete the application;

counselors can assist when needed 2 application types:

• Application for Health Coverage and Help Paying Costs (ACA-2) In general used by applicants under age 65

• Application for Health Coverage for Seniors and People Needing Long-Term-Care Services (SACA-2)

For applicants 65 and older Pink sheet indicates which application is used for each MassHealth

program

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Application Processing Applications sent to and processed at the Central Processing Unit or

MassHealth Enrollment Centers (MEC) If an application is received and requires further verification, applicant will

receive a Request for Information with a deadline by which to return the needed documentation

Retroactive Coverage:• Applicants age 65 and older can receive retroactive coverage up to 3 full

calendar months prior to the date of application• Applicants under age 65 can receive retroactive coverage beginning 10

days prior to the date of application Does not apply to MassHealth Senior Buy-in

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Payment For Services

MassHealth is always the payer of last resort

Any other insurance plan, including Medicare or employer-based health plans, must pay first before MassHealth will pay.

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Special MassHealth Programs In addition to the MassHealth Standard benefits

and eligibility criterion just discussed, there are several MassHealth programs that provide various levels of benefits for individuals who meet specialized eligibility guidelines

These programs act like Medicare Supplements (Supplement 1), covering co-pays and deductibles and offering additional benefits

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Medicare Savings Programs: MassHealth Senior Buy-In

Federally referred to as the Qualified Medicare Beneficiary (QMB)

• Eligibility Be entitled to Medicare Income at or below 100% of the FPL Assets at or below the designated limits (change yearly)

• Benefits Payment of Medicare Part A & B premiums Payment of deductibles and co-pays Deemed eligible for Full Extra Help

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Medicare Savings Programs:MassHealth Buy-In

Federally referred to as Specified Low-income Medicare Beneficiary (SLMB) and Qualified Individual 1 (QI-1)*

QI-1 subject to periodic federal funding appropriation

• Eligibility for SLMB and QI-1 Be entitled to Medicare Have income at or below: QI-1= 135% of the FPL SLMB=120% of the FPL Assets at or below the designated limits (change yearly)

• Benefits Payment of Medicare Part B premium Deemed eligible for Full Extra Help

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Buy-In ForPart B Late Enrollees

Late enrollees for Medicare Part B who qualify for the Senior Buy-in (QMB) or Buy-in (SLMB/QI-1) may enroll in Part B outside of the General Enrollment Period

The effective date of Part B coverage would not be earlier than the Buy-in start date

The individual’s late enrollment penalty will be paid for by MassHealth

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Caretaker Relative Eligibility

• Must meet the definition of a caretaker relative: Adult of any age who is primary caregiver for a child (can be related to the child by blood, adoption, marriage, or be the spouse/ex-spouse of one of these relatives). Must live in same home as the child and neither of the child’s parents can be living in the home

• Must have income at or below 133% of the FPL Benefits

• Eligible individuals will receive MassHealth Standard benefits• Payment of Medicare Part A & B premiums, deductibles and co-pays• Deemed eligible for Full Extra Help

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CommonHealth Eligibility

• Must have a disability• Must be ineligible for MassHealth Standard• Must currently be working at least 40 hours per month, or currently working and worked

at least 240 hours in the past 6 months MassHealth flexible on what “work” is

Must be paid work; cannot be volunteer Individuals under age 65 can waive the work requirement if they meet a one-time

deductible

• NO financial eligibility requirements Individuals with incomes above 150% of the FPL will pay a monthly premium relative to

their income

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CommonHealth, cont Benefits provided

• Benefits similar to MassHealth Standard including payment for Part A and B co-payments and deductibles

• Deemed eligible for Full Extra Help

Benefit NOT provided• Automatic payment for Part B premium

Individuals must separately meet the qualifications for Buy-in in order for MassHealth to pay premiums

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Frail Elder Waiver Allows elders eligible for nursing home care who want to remain at home to

get the services & supports to be able to live safely

Eligibility• Be age 60 or older• Be clinically eligible for nursing home care & receive services from the

ASAP’s home care program• Have income at or below 300% of the Federal SSI Rate• Have assets at or below $2,000

Only counts the income & assets of the applicant even if married; any assets over $2,000 limit allowed to be transferred to non-applying spouse

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Frail Elder Waiver, cont Benefits

• Payment of Medicare Part A & B deductibles and co-pays• Deemed eligible for Full Extra Help• No co-pays for prescription drugs• Supportive services (ex. Personal care, homemaking, meals)

To Apply• To apply the individual should be referred to their local Aging Service

Access Point (ASAP) ASAP staff will evaluate the applicant for clinical eligibility

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Health Safety Net (HSN) Pays for medically necessary services at Massachusetts community health centers (CHCs)

and hospitals 2 levels of eligibility: Full and Partial

Eligibility• Must be a Massachusetts resident

Non-residents may receive emergency or urgent care only

• Full Health Safety Net Income must be at or below 200% of FPL

• Partial Health Safety Net Income must be above 200% but at or below 400% of FPL Individual will be assessed an annual deductible

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Health Safety Net, cont. Benefits

•Low co-pay prescription coverage Prescription must be filled at a HSN pharmacy

•Will pay for allowed services not covered by Medicare, as well as Medicare co-pays, coinsurance, and deductibles

Services must be delivered/ billed through a hospital or community health center that has an HSN program

•Can pay for services up to 6 months prior to approval

HSN is NOT considered “creditable coverage” for Medicare Part D therefore use of the HSN pharmacy benefit does not protect a beneficiary from the Part D late enrollment penalty

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Senior Care Options (SCO) Combines MassHealth Standard coverage with social support services

and coordinated care to help individuals maintain their health and live in the community

Eligibility• Be 65 or older• Qualify for MassHealth Standard • Live in a designated service area of a SCO plan• NOT be diagnosed with End Stage Renal Disease• NOT be an inpatient in a chronic rehabilitation hospital

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SCO, cont. Benefits

• No co-pays or deductibles• Coordination of health care• Prescription drugs without a co-pay• Comprehensive dental, including dentures• Transportation• Specialized geriatric support services• Adult day care• 24 hour access to medical support• Home care services• Family caregiver support

•  

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One Care Managed care option that provides all Medicare & MassHealth services along with

additional care coordination and support services to dual-eligible individuals with disabilities• Members can only receive covered services through plan’s network of contracted

providers• One Care is not available in all counties

Eligibility• Be age 21-64• Have Medicare Parts A & B• Have MassHealth Standard or CommonHealth

Cannot also be enrolled in SCO, PACE, Frail Elder Waiver, or other MassHealth waiver program

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One Care, cont. Benefits

• All guaranteed Medicare and MassHealth benefits as well as: No premiums, deductibles, or co-pays Services coordination by an interdisciplinary care team Part D Coverage and no co-pays for prescription drugs Enhanced behavioral health and substance abuse services Long-term support Home modification Comprehensive dental Hearing aids Transportation

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Program Of All-Inclusive Care For The Elderly (PACE)

Provides community based care & services to people age 55+ who would otherwise require nursing home level of care• Team of health care professionals provide integrated care plan to keep

individual safe at home Eligibility

• Be age 55 or older• Be clinically eligible for nursing home care• Income at or below 300% of the Federal SSI Rate, assets at or below $2,000• Live in the service area of a PACE organization

PACE is not available in all regions of the state

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PACE, cont. Benefits

• No premiums, deductibles or co-pays for dual-eligible's; Medicare only beneficiaries will have monthly premium

• Provides all services covered by Medicare and MassHealth Standard

• Provides functional, social, and psychological services to help individuals safely remain in their homes

• Part D coverage through the PACE plan

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MassHealth Personal Care Attendant (PCA) Program

Program that helps people with long-term disabilities live independently at home by giving member funds to hire a personal care attendant (PCA) to help with activities of daily living (ADL’s)

Eligibility• Be age 65 or older• Have a permanent and long-lasting disability• Must need assistance with at least 2 ADL’s

ADL examples: Dressing, eating, bathing, walking• Income at or below 133% of the FPL• Assets at or below $2,000 for an individual or $3,000 for a couple

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Long Term Care (LTC) MassHealth

Pays the nursing home the difference between the patient private paid amount and Medicaid established rate for nursing home care. Requires clinical eligibility.

Financial Eligibility• No income limit; applicant just must have monthly income insufficient to pay

for nursing home costsTo prevent impoverishment of community spouse, spouse may be able to

keep some of applicants income, called the monthly maintenance needs allowance

• Assets limited to $2,000Community spouse allowed to keep all assets (not counting the primary

residence) up to a certain amount

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Review1. What does “dual-eligible” mean?

2. What are the different types of MassHealth applications and which application is used for which MassHealth program?

3. What MassHealth programs are specifically for individuals with a disability?

4. What is Health Safety Net and what does it provide?

5. What benefits are available from One Care?

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Case Study 1:Anna Stetick

Anna: 73 year old retired widow lives in senior housing Income: Social Security $1250/month (Net) Assets: $3300 in her checking account, $9,000 in savings Anna tells you that she moved here from Florida one month ago. She

was in a MA plan in Florida and knows she needs to pick a plan in Massachusetts. She also knows she will lose her Part D coverage with the Florida plan and was told she can’t enroll in a plan in Massachusetts until open enrollment and will have a penalty. She wants to know if she can get on MassHealth to pay for her prescriptions.

• How would you help her?

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Case Study: 2Robin Hood

Robin: 76 years old single, retired, living in senior housing Income: Social Security: $1,133/month (Net) Assets: $2500 in savings, $1000 in checking, car valued at $4000. He

has a life insurance policy with a face value of $10,000 and a cash surrender value of $1200

Insurance: Medicare A & B effective 3/1/03 and currently enrolled in the BCBS PPO plan

A friend told Mr. Hood to talk to a SHINE counselor about getting on MassHealth.

• How would you help him?

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Case Study: 3Donna Wannago

Donna: 77 year old retired widow who lives in senior housing Income: Social Security $816/month (Net) Assets: $1500 in savings, $200 in checking, life insurance policy with a face

value of $1200, car valued at $4000 Insurance: Medicare A & B effective 1/22/02 & Medex Bronze Donna signed up for a Part D plan during open enrollment although she

wasn’t taking any drugs at that time. She said she she chose the least expensive plan. She is worried about paying the Part D premium along with her Medigap . Her doctor just put her on medication and she doesn’t know how she will be able to pay for it during the gap in coverage under Part D.

• How would you help her?

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Case Study 4:Polly Gimmee

Polly meets with you on May 10th. She tells you she is 64 and has been on MassHealth due to a disability for the past 19 months. She says she is turning 65 in July and will be enrolled in Medicare effective July 1st. She will be receiving a Social Security check in the amount of $1102. A friend told her that her MassHealth might change when she turns 65. She is worried about her health care coverage if MassHealth does change particularly because she takes several medications and has no other income or assets to use to pay for them. She wants to know if it’s true that MassHealth might not continue to cover her. • How would you help her?

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Case Study 5:Mel Kontent

Mel meets with you at the SHINE office. He is very confused about the Medicare Prescription Drug Program. He tell you he takes several medications and gets some coverage through his Medicare Advantage HMO plan and that he used to get additional coverage through Prescription Advantage. He did fill out the application for Extra Help that Prescription Advantage told him to complete, but he received a letter that he was denied. He tells you he cannot afford his co-pays for his drugs since he lost his Prescription Advantage.

• How would you help him?

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Case Study 6:Martin Eyz

Mr. Eyz retired at age 65 and is collecting Social Security. He has Medicare and Medex Bronze. He takes no medications and never signed up for Part D. Mr. Eyes recently took a part-time job at the local Whypaymore to supplement his income. He lives in senior housing, so his rent is affordable. Mr. Eyes tells you that he is having a difficult time paying for his health insurance and was told by a friend that he should apply for MassHealth which would cover his medical expenses. Mr. Eyes tells you that he gets $750/month from Social Security and $300/month from his job at Whypaymore. He has $600 in a checking account and $1,400 in a CD. • Is he eligible for MassHealth?

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Case Study 7:Arthur Ritis

Arthur calls for assistance. He received an Eligibility Review Form (ERV) from MassHealth to complete. He doesn’t understand why he received the form since he is not on MassHealth. He had applied in the past but was denied because he was over income ($1596.40/month). He tells you he is homebound and called because he cannot come in for an appointment.

• How would you help him?

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Case Study 8:Ben Hurr

Ben is 57 years old. He has been on Medicare A & B since January. He was on a few inexpensive medications that he was filling at Wal-mart at little cost. His meds are changing and he now has a few expensive brands. His income is $1,900/month, and he has partial Health Safety Net. An advocate at the community center suggested he see a doctor at the community health center in a nearby town so that he can fill his prescriptions at the health center. She told him he can sign up for Part D at the next Open Enrollment Period.

• What additional information would you provide?

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Case Study 9:Charlie Horse

Charlie meets with you for help with his prescription coverage. He is in a Blue Cross PPO Medicare Advantage plan with prescription coverage. He takes several medications, one of which, Procrit, is quite expensive. His plan has been covering it, but he will be in the donut hole soon and is concerned because he can’t afford to pay the full price for his drug. He tells you he used to be in Prescription Advantage but that ended in January. He says his monthly income of $1,585 makes him ineligible for any benefit programs. He is not a veteran.

• How would you help him?

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Case Study 10:May B. Poor

May will be 65 and retiring in 2 months and will not have retiree coverage available through her former employer. She just heard about Medicare Part D. She only takes 1 drug now and doesn’t really want coverage. However, she heard she will pay a penalty if she enrolls at a later date should her drugs increase, as she believes they might. She is concerned about the monthly premium along with the premium for health insurance. She states that her only income will be Social Security and the amount she’ll receive will be $1,120/month. She tells you her savings are minimal and she has no other assets other than her home and a car. She wants to know if there is any way she can cut down on her health care costs or avoid taking Part D as she feels the additional premium will put her over the edge. • How would you help her?

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Public Benefits Quiz1. List the MassHealth Buy-In programs and the benefits they provide.

2. To be eligible for MassHealth an individual cannot own a home. True or False

1. When determining an individual’s eligibility for Supplemental Security Income (SSI), their living arrangements are considered.

True or False

4. If a Medicare beneficiary has MassHealth, do they need to purchase a Medicare Supplement or join a Medicare Advantage Plan?

Yes or No Why?

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Public Benefits Quiz, cont.5. What are the major differences between MassHealth for

individuals under 65 and those 65 and over?

6. What resources are counted in the asset test for people over 65 who apply for MassHealth while living in the community?

7. An individual whose assets are too high for MassHealth Standard can spend down assets in order to qualify on medical expenses only.

True or False

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