Deciphering Medicare and Medicaid
November 9, 2012
As you age, you will be faced with many difficult decisions, not the least of which is how to pay for mounting medical costs.
Medicare and Medicaid are two government programs that purport to help you pay for care. But often these programs are insufficient, encourage you to impoverish yourself, and offer poor quality of life. Proper planning, however, can help you avoid these obstacles, and maintain your independence.
Medicaid. Medicare. These terms can be confusing. People often mix them up, or think that one provides more medical coverage than it actually does.
Medicare is a program for anyone who is 65 years or older, or deemed disabled by the Social Security Administration.
It is a program that is available regardless of your financial status. It is, in a very broad sense, medical insurance for our elderly citizens.
Like insurance, it provides limited care for acute medical conditions. Like insurance, there are deductibles, copays, and limitations on coverage. For example, Medicare only provides coverage for 100 days in a skilled nursing facility in any calendar year.
While Medicare covers the first 20 days of costs, the next 80 days are subject to a copay by the patient. After 100 days, the patient is 100 percent responsible for the cost.
Medicare, as you can see, is an incomplete solution for covering the cost of medical care. The challenge many seniors are facing is how to pay for this gap in coverage. Some consider using Medicaid.
Medicaid is a program to provide medical care for low-income individuals. In Nevada, to qualify for Medicaid, an unmarried individual must be disabled (which is measured by qualifying for Social Security disability) or over 65, earn no more than $2,084 per month, and have no more than $2,000 in a bank account. Certain assets are not considered by Medicaid in determining your qualification, including a home with less than $500,000 in equity, or a vehicle.
However, as you can see, a person must essentially have no liquid assets and be living near or below the poverty level to qualify for Medicaid.
Medicaid is designed to be used for chronic conditions requiring long-term care, such as home caregivers, nursing home care, and the like. It covers the cost of medical care 100 percent.
Medicaid is not the only solution for paying for the cost of medical care not covered by Medicare. With proper planning, and support from appropriate professionals and family and friends, our seniors do not have to impoverish themselves to pay for medical coverage.
Medi-gap insurance programs, long-term care insurance, savings, and proper planning can shelter your assets from having to be spent down to access government benefits while at the same time helping you maintain your independence and minimizing the burden on your family.
Cassandra Jones is an elder law and family law attorney in Gardnerville. She can be reached at 782-0040.