For Long-Term Care, what is the difference between Medicare and Medicaid?

May 11th, 2015 by beasleyferber

Most people confuse Medicare and Medicaid. The names are similar, but that’s where the similarity ends. Here is a brief description of the two programs, which are very different.

Medicare is the basic health insurance program available to anyone who is disabled or over 65 and has paid into the Social Security system. It has nothing to do with your income or assets. Many people believe that Medicare pays for long-term nursing home care. However, people who belief this and who later enter a nursing home are in for a very unpleasant and expensive surprise, since Medicare is not designed to cover long-term nursing home care. If a Medicare beneficiary spends three nights in the hospital and then goes to a nursing home for rehabilitation, Medicare will pay the nursing home in full for the first 20 days, and then in part from day 21 to 100. However, once the patient stops making improvement, Medicare and the Medicare supplement stop paying, even if this occurs before expiration of the hundred days. Thus, Medicare for skilled nursing care is meant to be a short-term benefit only. People who need long-term nursing home care are not covered. A person’s eligibility for Medicaid, by contrast, is asset dependent. Generally speaking, an unmarried person is eligible for Medicaid when his or her assets fall below $2,500 in New Hampshire and $2,000 in Massachusetts. For a married couple in Massachusetts, the healthy spouse can keep about $119,000 in assets, and in New Hampshire, he or she can keep half the assets or $119,000, whichever is less.

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