There is quite a bit of confusion about Medicare and Medicaid, and what each covers. If you are helping a loved one that is facing the need for long-term care, it’s important you understand what resources are available, and how to qualify.
Medicare
Medicare is funded by the federal government, and administered by the state. It is a health insurance program designed for senior citizens (over 65 years of age.) Medicare covers some long-term care costs. For example, if you are enrolled in the traditional Medicare Plan, your nursing home stay will be covered for the first 20 days, as long as you stayed in a hospital for a minimum of three days prior, and the next 80 days is covered after you pay a daily deductible. Medicare supplemental insurance programs often cover the deductible. The facility must be a skilled nursing care facility to qualify.
Medicaid
Medicaid is primarily funded by the federal government, and also administered at the state level. Medicaid will pay for long-term stays in a nursing home, unlike Medicare, which only covers skilled nursing facilities. Medicaid also pays for custodial nursing stays, which Medicare does not. A custodial stay refers to someone needing to be a nursing home due to Alzheimer’s or Parkinson’s disease.
Medicare will pay no more than 100 days of care for each spell of illness, and most of the time falls short of the 100 day maximum. After that, the burden of paying for the care falls on the individual and his or her family, long-term care insurance or qualifying for Medicaid.
