Medicare vs Medicaid

I received a phone call the other day from a friend looking into assisted living for her mother.  She wanted to know if she should apply for Medicaid first.  In the course of the conversation, she sometimes said Medicaid and sometimes said Medicare.  They are completely different programs.

From the book:

When my parents became ill, they had little money set aside – no thought to long term care, no end of life planning, no rainy day jar to help cover possible medical costs.  They had been living mostly off their Social Security and a little savings from the sale of their house.  They hadn’t considered a situation like this could occur and my brothers and I were not financially able to offset them.

As my father began to recover, he agreed to make me his financial Power of Attorney (POA).  This legal title gave me access to their checking account and the payment of bills piling up on the kitchen table.

My father always paid all bills in full each month.  He took pride in doing so.  Growing up, we’d make ourselves scarce the one night each month he’d take the dented green strong box from under the bed and settle in at the kitchen table to pay out the monthly expenses – a Marlboro in one hand, a pen clenched in the other.  He was known to lose his temper, but on ‘bill-pay night’, you could count on it.

Dad seldom cussed (unlike Mom who was quite creative in expressing her verbal ire), but watch out when he’d yell, “Jumpin’ Jehassafat and all his little disciples!”  It was commonly shouted on bill-pay night and when I sat down for the first time in front of their growing pile of unopened mail, I could hear him cursing.

Medicare and Medicaid are entirely different programs.

In short, Medicare is our government health insurance program for people over 65 and those on Social Security disability. Medicare is a medical insurance program that provides coverage for hospitalization, doctors, prescriptions and other types of medical expenses.

Except for a limited short term nursing home benefit (after a qualified stay in the hospital), it is NOT coverage for nursing home or other long-term care like assisted living.

Medicare will help cover a short-term nursing home stay if the elderly patient has been in the hospital for at least three nights prior to entering a facility and Medicare deems the additional care to be medically benefiting (like speech, physical and/or occupational therapy). Custodial care is not covered.

Under no circumstances does Medicare pay for assisted living, residential care facilities or adult foster/day care.  Medicare has some benefits for home health care (after an extended illness), but not for caregivers to come in and attend to the personal needs of someone on a long-term basis.

Medicaid, on the other hand, is funded both by the federal government and each individual state (this means qualification guidelines differ from state to state).  It is the program that provides benefits for subsidized assisted living, long-term nursing home care and possibly benefits for other types of long-term care, but a person must qualify financially for Medicaid (low income/asset eligible).

You can visit http://www.cms.gov/ for more information on both programs…and good luck.  You’ll need it!

PS…I suggested the friend contact ‘A Place for Mom’ at http://www.aplaceformom.com.  They were an incredible help for us.

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About hereisakiss

Daughter Writer Art's Educator
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