Medicaid can provide different kinds of coverage than Medicare does. Medicaid can be invaluable in providing help to seniors who struggle to afford the cost of Medicare’s coinsurance and who have difficulty affording prescriptions and services that Medicare does not cover. In addition, one of the most important things that Medicaid can do for seniors is to cover the cost of custodial care in a nursing home setting, which most private insurers do not provide coverage for.
While Medicaid can be very important in helping seniors afford their care, the problem is that Medicaid is only available in very limited circumstances. Medicaid is means-tested, which means that it is a program for the needy which only people with limited incomes and limited resources can become qualified for.
Many seniors who meet the income criteria have assets they have worked to acquire during their lifetimes, and these assets can prevent Medicaid from covering them. This is a major issue for seniors, who sometimes are forced to spend their money and even sell assets they have worked for in order to pay medical bills or nursing home bills. Only once they have spent down their nest egg can they get the benefits they need.
There are options to try to cover for Medicaid sooner, which Eghrari Law Firm can help seniors to explore. You should contact our Medicaid attorneys to discover the ways in which we can assist you in qualifying for coverage when you need it.
Does Medicaid Cover More than Medicare?
Medicaid and Medicare are very different insurance programs. Medicare is available to virtually all seniors, and provides coverage for hospital care through Medicare Part A; routine care through Medicare Part B; and prescription drugs through Medicare Part D. Seniors also frequently purchase Medicare advantage plans or supplementary plans so they can get additional coverage.
For most types of services, Medicare pays only a portion of costs and seniors are required to pay coinsurance costs. Medicare has many coverage restrictions, and many seniors have to pay premiums both for Medicare and for their supplemental insurance policies. For seniors who are on a tight budget, being able to pay for these expenses can be very financially burdensome.
Medicaid, on the other hand, can pay the Medicare deductibles for eligible seniors and can pay the coinsurance costs, which can be as high as 20 percent. While there may be very small Medicaid charges for some services, often most medical care is provided to Medicaid patients free of charge. Patients on Medicaid can also typically get coverage for things that Medicare won’t pay for at all, such as hearing aids.
Since Medicaid can help seniors to pay for the costs they are still left to cover when they have Medicare, qualifying for Medicaid is important for people who are older and who have limited incomes.
Medicaid and Nursing Home Care
While there are lots of reasons to try to qualify for Medicaid as you get older, one of the single most important reasons why seniors may need Medicaid is because of nursing home bills.
Nursing homes are extremely expensive, often totaling hundreds of thousands of dollars a year. Medicare only pays for limited periods of time in nursing homes, and only when skilled services are being received. If a patient needs custodial care, which is normal routine daily help like most nursing home patients need, then Medicare won’t offer coverage. Most private insurers won’t pay for custodial nursing home care either. As a result, Medicaid may be the only source of payment for nursing home bills, other than privately paying.
If you have to privately pay because you don’t qualify for Medicaid coverage, you will likely spend all of your money very quickly. You could end up selling assets once your savings is gone. Only after you have diminished your wealth below the Medicaid resource limit will Medicaid finally begin to pay for your nursing home care. You deserve to be able to leave your money and property to the people you love, not see it lost due to nursing care- so you don’t want this to happen to you. The good news is, Medicaid planning can make it possible to take steps to protect assets and still get benefits.
Getting Help from a Medicaid Planning Lawyer
A Medicaid planning lawyer can provide you with assistance in ensuring that you can qualify for Medicaid coverage when you need it. Contact Eghrari Law Firm today to speak with a member of our legal team and learn more about the Medicaid planning process. Give us a call at (631) 265-0599 or contact us online to find out how we can help you.
Mark S. Eghrari, Estate Planning Attorney
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