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Medicaid planning versus Medicare

Medicaid/Medical Assistance Planning helps people to protect themselves, their families and their assets. Many people, including Pittsburgh residents, probably routinely confuse the terms Medicaid and Medicare, assuming that since they both may pay for some long term care, they must operate in the same way. However, payments for long term care by Medicaid is different from the insurance payments by Medicare.

First, Medicare is insurance for individuals over 65 or who are disabled. Medicare is usually funded for through payroll withholding when individuals or their spouses are working. Medicaid, on the other hand, is welfare that may help people in financial need who also require medical or long term care. In order to become eligible for Medicaid, people must have both limited income and limited assets. People who do not engage in timely Medicaid/Medical Assistance planning may lose out.

The specific rules regarding Medicaid eligibility differ from state to state, but the basics are the same - once a person is eligible for Medicaid for long term care, he or she will have limited income and few assets. If an individual has savings, those savings may have to be used to pay for long term care prior to applying for Medicaid. However, many people want to provide for their spouse or their children's future and would prefer not to use those savings on this care. Timely long term care planning can allow people to protect their spouse or their children's inheritance while not affecting their own eligibility for Medicaid.

Giving away assets does not affect Medicare. On the other hand, a transfer of assets can make one ineligible for Medicaid if it is done within five (5) years of applying for such benefits. Therefore, those who may need long term care in the future should start planning now in order to avoid falling within the so-called look back period. There are also other steps that can be taken to help obtain Medicaid eligibility and an experienced elder law attorney may be able to guide Pittsburgh residents through the process.

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