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What is the Difference Between Medicare and Medicaid?

Difference Between Medicare and MedicaidAlthough Medicare and Medicaid are both federally funded health insurance programs, they have different eligibility requirements and the benefits differ.

Who is eligible for Medicare? Who is eligible for Medicaid?

Medicare is an entitlement program. This means that if you have worked and paid into the system by way of deductions from your paycheck, generally you’re entitled to receive Medicare health insurance when you retire (or reach retirement age) and begin receiving social security benefits. Medicare Part A covers hospitalization; Part B covers bills from doctors and other providers you see on an outpatient basis.

Medicaid is a means-tested program that’s meant for people with limited resources and limited monthly income. To be eligible for Medicaid in 2017, you generally can’t have more than $14,850 in assets (with limited exceptions). If you have more than $14,850 in assets, you may be able to implement planning to become eligible to receive Medicaid. We help clients with Medicaid eligibility in our office.

Do Medicare and Medicaid cover long-term care or home health care?

Medicare does not cover long-term care either at home or in a nursing home. As noted above, it covers hospitalization. It also covers short-term rehabilitation (up to 100 days). Even if you need rehabilitation beyond 100 days, Medicare will not cover it; to pay for that care, you will have to pay for it yourself, pay for it via separate long-term care insurance benefits, or apply for Medicaid benefits.

Medicare also doesn’t cover home care beyond a short period (typically two weeks) following a hospitalization. By contrast, Medicaid can cover long-term care at home.

If you or someone you know is or may be in need of long-term care, or you are concerned about protecting your assets from a long-term illness, planning in advance is critical to preserve their dignity and protect assets.

Contact us with questions or comments today.


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