![]() ![]() He or she can guide you through the complicated rules of the different programs and help you plan ahead. But to be certain of your rights, consult an expert. The rules for gaining eligibility to the program are explained in detail in the Medicaid section of this site. ![]() (The states also sometimes have their own names for the program, such as "MediCal" in California and "MassHealth" in Massachusetts.) Both the federal government and most state governments seem to be continually tinkering with the eligibility requirements and restrictions. This complicates matters, since the Medicaid eligibility rules are somewhat different from state to state, and they keep changing. (The state picks up the rest of the tab.) Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive federal money, which pays for about half the state’s Medicaid costs. So to be eligible for Medicaid, you must become "impoverished" under the program’s guidelines.Īlso, unlike Medicare, which is totally federal, Medicaid is a joint federal-state program. Medicaid, on the other hand, is a form of welfare - or at least that’s how it began. For one thing, all retirees who receive Social Security benefits also receive Medicare as their health insurance. Although their names are confusingly alike, Medicaid and Medicare are quite different programs. Lacking access to alternatives such as paying privately or Medicare, most people pay out of their own pockets for long-term care until they become eligible for Medicaid. Check out the Medicare section of this site for tips on making sure you receive the nursing care benefits to which you are entitled.įor all practical purposes, in the United States the only "insurance" plan for long-term institutional care is Medicaid. As a result, Medicare pays for only about 9 percent of nursing home care in the United States. However, the definition of "skilled nursing" and the other conditions for obtaining this coverage are quite stringent, meaning that few nursing home residents receive the full 100 days of coverage. Medicare Part A covers up to 100 days of "skilled nursing" care per spell of illness. ![]() Veterans may also seek benefits from the Veterans Administration. This can be done by purchasing long-term care insurance or by making sure you receive the benefits to which you are entitled under the Medicare and Medicaid programs. The disadvantage is that it’s expensive.Ĭareful planning, whether in advance or in response to an unanticipated need for care, can help protect your estate, whether for your spouse or for your children. The advantages of paying privately are that you are more likely to gain entrance to a better quality facility and it eliminates or postpones dealing with your state’s welfare bureaucracy-an often demeaning and time-consuming process. ![]() Then they can qualify for Medicaid to pick up the cost. Most people end up paying for nursing home care out of their savings until they run out. Depending on location and level of care, nursing homes cost between $35,000 and $150,000 a year. This not only means a great loss of personal autonomy, but also a tremendous financial price. One of the greatest fears of older Americans is that they may end up in a nursing home. The advantages of paying privately are that you are more likely to gain entrance to a better quality facility and doing so eliminates or postpones dealing with your state’s welfare bureaucracy-an often demeaning and time-consuming process. Depending on location and level of care, nursing homes cost between $40,000 and $180,000 a year. ![]()
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