By Trudy Lieberman 

Over the past few months, these columns have raised plenty of questions about Medicare, present and future, and I’ve received many responses to those questions from readers. Today’s column addresses some of readers’ concerns about Medicare, a complicated program.

A: Anyone age 65 and older and first signing up for Part B (which pays for doctors’ services and outpatient care) and in some states people with disabilities first signing up for Part B may be able to get a Medigap within the first six months of eligibility for Medicare. After that it depends on your state’s rules. Check with your local SHIP program to learn what they are.

Q: I am very happy there’s going to be Medicaid reform. I am a dental hygienist who worked in a practice that has seen has many Medicaid patients. Many of these people were illegal. Some couldn’t even speak English. I am on the door of seniorhood but LOVE the idea of Medicaid reform. We can save millions, probably billions, by putting people to work who can work. CW

A: The column you refer to discussed Medicare, not Medicaid.  The programs are not the same. Medicaid was not designed as a seniors’ program, but 20 percent of Medicaid expenditures are for long-term care.

The lack of such care for families has meant that Medicaid, a welfare program, has become a long-term care program by default for many middle-income seniors. Congress is considering cuts to both programs that could result in seniors paying a lot more out of pocket.

Q: My husband and I are hoping this administration doesn’t ruin this program by making it private. It has worked very well for a long time and should be left alone. If this program is made too expensive for seniors, the doctors will be seeing far fewer patients. BC

A: It is well known that seniors are risk-averse, meaning they are afraid of big medical bills they can’t afford. That explains the popularity of Medigap policies, especially the ones that cover the portion of a doctor’s bill that Medicare doesn’t pay, in effect giving seniors nearly full coverage. Many in Congress want to change that. Beginning in 2020, insurers will be prohibited from selling those kinds of Medigap policies to people new to the program. (Those who already have such a policy can keep it.) The idea is to make seniors have more skin in the game by paying more for their care as a way to save money for the government.