Is There a Difference between Medicare and Long Term Care Medicaid?

Is There a Difference between Medicare and Long Term Care Medicaid? article image

For many people there is a general misunderstanding regarding the two programs: Medicare and Medicaid.

Medicare is a nationwide, age based, governmental health insurance program funded by the Social Security Administration. Most of us, as taxpayers, will contribute to this fund while we are working. There is also a monthly premium that is paid for the level of insurance you choose to enroll in. You become eligible for the benefit when you turn 65, so it is an age based program. Some people with certain disabilities may be eligible for the health insurance before they turn 65.

There are different levels of Medicare. The most common levels consist of A, B & D. Medicare Part A assists with temporary inpatient care in hospitals and temporary rehabilitation stays at a skilled nursing facility. Medicare Part B assists with doctor’s services and outpatient care. Medicare Part D assists with prescription drug coverage. Medicare does not pay for long term care.

Medicaid is a multi-faceted program that covers many medical needs of those in our community. The level of Medicaid most commonly confused with Medicare is long term care Medicaid. Medicaid is a Government assistance program and because of that it is a needs based program. Medicaid is a State administered benefit program that allows persons to apply for the benefit to pay for their long term care.

There are additional ways to pay for long term care. Such as long term care insurance, privately pay with savings and other assets, the Medicaid long term care program or the Veterans Aid & Attendance Pension program. Contrary to Medicare, in order to receive the long term Medicaid benefit you must prove eligibility. The State of Delaware has a three part assessment that you must pass in order to become eligible for the benefit. You must medically need care, and you must qualify under the State’s income and asset rules.

There are several myths surrounding the Medicaid long term care program. One of the most common is that an applicant will not qualify without spending their savings, including selling assets like a residence, first. Legal planning with a specialized elder law firm can oftentimes create eligibility for this benefit much sooner than anticipated.