Posts

mark diamond arizona, mark diamond senior education counsel, Senior Education Counsel, a nonprofit Since 1995, Arizona, California and North Carolina Mark Diamond, national senior advocate

Medicare, Medicaid

Medicare, Medicare, Medicaid. We talk about it and hear about it, but it never seems like we’ve completely grasped what they are and what they do. So, let’s dive into some facts to understand what they are, what they do, and what the difference is between the two.

Medicare is a health insurance that is designed to help people who are either 65 years or older, or have certain disabilities even if they are under 65. People who have End-Stage Renal Disease of any age are also eligible for Medicare. Medicare helps cover inpatient care, hospice, nursing facilities, usually without a monthly premium. With standard monthly premium, Medicare also helps cover outpatient, home health, and services from doctors and health care providers. Medicare also contracts with private insurance companies to provide extra benefits, as well as help cover prescription drugs.

Medicaid, on the other hand, is a joint program between the states and the federal government that helps cover medical care of people who have limited income. Medicaid may provide additional coverage that includes Long-Term Care and personal care. Eligibility for Medicaid depends on the particular state you live in, but can include requirements such as age over 65, children under 19, pregnant women, and disabled persons. Medicaid may cover primary care, in hospital care, preventative care, mental health services, pregnancy care, and medications.

It is also possible to qualify for both Medicare and Medicaid, which is called “dual eligibles.” For more information on qualifications and coverage, visit https://www.medicare.gov/ and http://medicaid.gov/.

References:

  1. Mark Diamond, National Speaker and Senior Advocate
  2. https://www.medicare.gov/Pubs/pdf/11306.pdf
mark diamond arizona, mark diamond senior education counsel, Senior Education Counsel, a nonprofit Since 1995, Arizona, California and North Carolina Mark Diamond, national senior advocate

How do you Finance Nursing Homes?

In 2050, more than a fifth of the population in the United States will be 65 years or older.1 This means more people will be limited physically and cognitively, which also means that more and more people will need assistance and likely end up in nursing homes. Nursing homes, which are basically 24-hour senior care facilities, vary in terms of cost and services provided. Nursing homes are licensed by its residing state as providing a certain level of personal and nursing care to its residents.

Knowing that there is a high probability that you or one of your loved ones will end up in a nursing home, it is critical to understand how to finance the cost of supporting someone who is living in a nursing home. Private or public support can be pay for nursing homes. Major payers for long-term services and support are Medicaid and Medicare, as they pay for two thirds of the total cost.2 They are also funded by private insurances, federal and state programs for the elderly, and private donations.

Medicare pays to cover short-term (3 months or less) rehabilitative care for those recovering from acute conditions, while Medicad and private long term insurance covers long-term care (3-5 years for private insurances, indefinitely for Medicaid).1

Most people do not prepare for their long-term care needs, which is a growing problem in the United States as more and more people require long-term care. This may end up in families and beloved ones covering the cost if the supported is not eligible for Medicaid or Medicare and not supported by private insurance. Therefore, it is critical to start thinking early in terms of retirement and possible long-term care needs for you and your spouse. The more prepared you are, the less you’re going to have to face when you retire.

References:

  1. Congressional Budget Office, Rising Demand for Long-Term Services and Supports for Elderly People (June 2013), http://www.cbo.gov/sites/default/files/44363-LTC.pdf
  2. Congressional Budget Office, Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies (June 2013), www.cbo.gov/publication/44308
  3. Mark Diamond, National Speaker and Senior Advocate