Common Misunderstandings About Medicare, Medicaid, and Senior Care

While people think they know about Medicare and Medicaid Services, there are quite a few misconceptions about these two government programs. Get to know these useful programs so you can make the most out of them and determine if they can help with your senior care needs.

Medicaid

This state-run federal program helps low-income families and individuals afford medical care. Once the state determines your eligibility, Medicaid can assist with how you might qualify for long-term care. Medicaid may cover personal care services, home health care, as well as long-term care in senior communities.  Coverage and eligibility will vary according to your location and needs.

What does Medicaid cover?

●       Services and care received as a patient in a skilled nursing facility or hospital. (Part A)

●      Care, services, and doctor visits received as a patient, along with preventative maintenance. (Part B)

●      Prescription drugs (Part D)

●      A Medicare Advantage plan (Part C) will often combine Part A and Part B coverage and may also include prescription drugs (Part D) all in a comprehensive plan.

Medicare

This federal program can help pay for the medical needs of people over 65 years of age, individuals under 65 years of age who have specific needs, and care for individuals of any age who suffer from end-stage renal disease. Medicare doesn’t generally cover long-term costs but can help pay a percentage of the price for a short stay in hospice care or a skilled nursing facility if conditions are met.

What does Medicaid cover?

●      Services and care from a skilled nursing facility or a hospital

●      Nurse midwife, doctor, along with family nurse practitioner, and certified pediatric services

●      Services and care from a federally-qualified rural health clinic, health center, or a freestanding birth center that’s recognized or licensed in your state

●      And more

Myth

Medicaid and Medicare are the same programs and will cover most of our senior health care costs. Because older adults have little out-of-pocket funds, they won’t have much incentive to restrict the use of the country’s healthcare system.

Reality

Medicare is capable of providing essential coverage for drug, physician, and hospital bills, along with short-term post-acute coverage of hospice care, home health care, and rehabilitation services. However, beneficiaries will need to pay a considerable amount from their own pockets. Furthermore, most nursing home stays aren’t qualified to be covered by Medicare. Also, most senior living community options are “private pay” and do not accept Medicare or Medicaid for their monthly fees.  

Other Options for Paying Senior Care

If Medicare and Medicaid aren’t viable options for your senior care needs, you can also choose from these options:

1. Long-term Care Insurance

This kind of insurance policy can reimburse seniors daily to assist with ADLs (activities of daily living).

2. Veterans Aid

Military veterans from the United States may be eligible to use their benefits to help pay for long-term care. Veterans might also be eligible to use their veteran’s pension and disability payment to pay for long-term care.

3. Real Estate Options

There are two ways to use our real estate assets to pay for senior living:

The first option is to use home equity, your home’s market value minus the liens’ balance on your property. Your home equity will increase and decrease along with your home’s value, so make sure it is well taken care of.

The second option is to use a reverse mortgage — this is only available to seniors over 62 years of age and won’t require monthly payments.

4. Life Insurance

Life insurance can give you various options towards paying for long-term care. If you’ve chosen a policy that has cash value, you may withdraw cash to pay for senior living. Your policy can also be sold in a “life settlement option” to pay for care.

For more details on Medicare, Medicaid, and other options on how you can pay for senior care, visit our Funding Guide. To talk directly with a Friendship team member, call 540.385.8720.  Know we are here to support you and your loved ones and provide peace of mind!

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