Are federal employee retirees ineligible for Medicare and Medicaid?

1 answer | Last updated: Oct 09, 2016
Karenleray asked...

My 84 yr old mom lives with us. She's a widow, didn't work after married 1948. Dad worked for the Federal Govt - VA Hospitals from 1947-@ 1980. My brother tells me mom can't have medicaid or medicare because Dad didn't pay into Social Security as a federal employee and has never applied. Is this info correct?

Expert Answers

Good news for you -- your brother's worries about your mother's eligibility for Medicare or Medicaid are NOT correct, and your mother is likely to be eligible for all parts of Medicare (and for Medicaid, too, if she qualifies financially). Let's take them one at a time.

Medicare Part A covers inpatient care in a hospital or skilled nursing or rehabilitation facility. To be eligible for Medicare Part A, a person age 65 or over must qualify for Social Security retirement, dependents, or survivors benefits OR retirement, dependents, or survivors benefits from a civil service retirement system. Since your father worked all those years for the federal government, your mother is probably eligible for Medicare Part A based on your father's federal employment since he was probably covered by the federal Civil Service Retirement System. Your mother may be eligible based on your father's work for the federal government regardless of whether he actually collected federal civil service retirement benefits.

Your mother is also eligible for Medicare Part B, which covers doctors and other outpatient care. She is eligible for Part B simply by being age 65 and a citizen (or legal resident for at least five years), regardless of her own work record or your father's employment. And because she's eligible for Medicare Part B, she is also eligible to choose a Medicare Part C Medicare Advantage plan instead of Part A and Part B, if she'd rather. She is also eligible to enroll in a Medicare Part D prescription drug plan.

Medicaid is a health insurance program that is completely separate from Medicare. Each state runs its own version of the program, and eligibility depends on having very low income and few assets other than the home you live in. Simply by being at least 65 years old and a legal resident of the state, your mother can qualify for Medicaid if she meets the specific financial limits of her state's Medicaid program.