Tag Archives: medicare

The Differences Between Medicare and Medicaid for Seniors

medicarevsmedicaid
by Erica Erickson

Most Americans have heard of Medicare and Medicaid, but many do not have a clear understanding of the differences between these two programs or the types of coverage they provide. The following is a brief overview of Medicare and Medicaid to help clarify the major differences between the programs.

Medicare is the federal health insurance program that offers coverage to everyone over 65 years of age and people under 65 with certain disabilities. Medicare Part A is the standard coverage, which covers hospitalizations, short term nursing home stays, and hospice care. Medicare Part B covers outpatient doctor visits and related appointments. Medicare Part D is prescription drug coverage. Medicare Part C is often referred to as a Medicare Advantage Plan, and is purchased through a separate insurance company. Part C policies typically cover Parts A, B, and D and may help cover copays and services not covered by standard Medicare coverage. Private insurance companies also offer a variety of other plans to help cover gaps in Medicare coverage.

Medicaid is a separate insurance program focused on providing coverage to people with limited resources. Medicaid is funded by both the federal and state governments and is administered by the state. There are many different Medicaid programs, most of which have specific income and asset limits. Most seniors who apply for Medicaid apply for programs to help them pay for their Medicare premiums and copays or to help them pay for assisted living, memory care, or long term skilled nursing care in a nursing home.

Because Medicare will only pay for up to 100 days of nursing home care, if a senior needs to stay in a nursing home for a longer period of time and cannot afford the cost (often exceeding $7,000 per month), the senior should apply for Medicaid for Long Term Care. There is no income limit to qualify for this Medicaid program, but the senior’s monthly income will go to pay the nursing home and then Medicaid will cover the balance. There are asset limits, but the senior can keep their home, one car, their household and personal belongings, and certain other assets, including cash and investments. If the senior is married and there is a spouse who will remain at home, that spouse can keep all of the assets listed above, their own income, plus up to about $119,000 cash or other assets, depending on their specific situation.

Medicaid has a 5 year look back period for gifts and if a senior gives away assets within 5 years of applying for Medicaid, they may be disqualified or penalized. The Medicaid application process is complicated and many seniors who may not think they qualify or who have been turned down in the past, may actually qualify for coverage. Additionally, there are many landmines and many ways seniors may inadvertently disqualify themselves from coverage, so before applying or after being turned down for coverage, it is strongly recommended that the senior consult an elder law attorney for guidance.

This article was written by Erica M. Erickson, an Elder Law and Estate Planning Attorney at Strauss & Associates, P.A., with offices in Hendersonville and Brevard, North Carolina. Erica can be reached at (828) 696-1811 or erica@strausslaw.com and she is happy to answer any questions you may have or to provide you with a free consultation regarding your estate planning needs, including Medicaid planning, wills, trusts, and more.

Navigating Medicare

Photo provided by  Peter Kaminski  through Creative Commons.

Photo provided by Peter Kaminski through Creative Commons.

Does sorting through Medicare lingo make you want to give up and go back to bed? You’re not the only one. Most of us need help navigating the system. John Wingerter of the Council on Aging of Buncombe County in conjunction with Seniors’ Health Insurance Information Program (SHIIP) announces the Medicare class schedule for Medicare Choices Made Easy. The information session explains how Medicare works, the enrollment process, how to avoid penalties and ways that beneficiaries can save money.

The information sessions are free and open to the public. People new to Medicare, caregivers, people leaving employer health insurance for Medicare and others who help Medicare beneficiaries with their insurance should consider attending this informative class. The information presented is unbiased as no products are sold, recommended or endorsed.

Classes are listed below. To reserve your place, register online at www.coabc.org or call the Council on Aging at 828-277-8288. For the Pardee classes you may register by calling the Pardee Signature Care Center 828-692-4600.

June 16 6:00 – 8:00 PM
Leicester Library
1561 Alexander Road, Leicester, NC 28748

June 17 2:00 – 4:00 PM
Fairview Library
1 Taylor Road, Fairview, NC 28730

June 18 3:00 – 5:00 PM
Pardee Signature Care Center
1800 Four Seasons Blvd, Hendersonville (Blue Ridge Mall)

June 23 6:00 – 8:00 PM
Skyland/South Buncombe Library
260 Overlook Road, Asheville, NC 28803

July 23 3:00 – 5:00 PM
Pardee Signature Care Center
1800 Four Seasons Blvd, Hendersonville (Blue Ridge Mall)

July 24 2:00 – 4:00 PM
OLLI/Reuter Center – UNCA
One University Heights, Asheville, 28804

July 31 2:00 – 4:00 PM
Goodwill
1616 Patton Ave, Asheville 28806

August 20 3:00 – 5:00 PM
Pardee Signature Care Center
1800 Four Seasons Blvd, Hendersonville (Blue Ridge Mall)

Contact John Wingerter with the Council on Aging of Buncombe County for more information. 828-277-8288  Johnw@coabc.org