Last time we looked at the difference between Medicare and Medicaid. Now let’s look at how they differ with respect to long-term care planning. Medicare, by and large, does not cover long-term nursing home care. For example, Medicare Part A will only cover up to 100 days in a skilled nursing facility for a particular illness, and only after the patient has spent at least three days in a hospital. Worse, from day 21 to day 100, the individual in the skilled nursing facility must make a copayment of $167.50 per day. Few people actually receive Medicare coverage for the full 100 days, in part because of the copay, and in part because restrictions and conditions for coverage are quite stringent. Medicaid, on the other, does cover long-term nursing home care for people who meet its income and asset limits. 100 days, one year, five years-Medicaid will pay for the
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Many people are confused about the difference between Medicare and Medicaid as it pertains to the challenge of paying for expensive long-term care. This is not surprising. The two programs sound similar and both provide for medical care. Let’s start with a brief definition of each program. Medicare is an entitlement program. Everyone who reaches the age of 65 and is eligible to receive benefits from Social Security can also receive Medicare. Medicaid, on the other hand, is a public assistance program. It is designed to help people with limited income and assets pay for medical care. Recipients of Medicaid assistance must meet certain income and asset guidelines. Another fundamental difference between the two programs is that Medicare is run entirely by the federal government whereas Medicaid is a joint federal-state program. Every state has its own Medicaid system, which helps explain why eligibility rules differ from one state to
Continue Reading... →Does Medicare cover a test or procedure recommended by your doctor? You’ll know at a glance if you use Medicare’s new “What’s Covered” app. This free app lets you search for specific services or browse a list of alphabetized services to determine what is covered by Medicare Parts A and B. You can also access basic information about costs. While the app provides an extensive list of the services, tests, and procedures covered (or not covered) by Medicare, it does not take into account a user’s specific co-insurance, supplemental insurance, or deductibles. The What’s Covered app is part of an initiative by the Centers for Medicare and Medicaid Services (CMS) to modernize Medicare and empower beneficiaries. Other CMS initiatives include price transparency tools, improved online support, and a webchat option on the Medicare Plan Finder. You can get the What’s Covered app from the App Store or Google Play by
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