Medicare and Medicaid Differences and Planning for the Future

 Posted on July 30, 2015 in Estate Planning

One of the most confusing decisions and choices that seniors need to make is about their health care insurance. People may have a hard time understanding the differences between Medicaid and Medicare and how those differences affect their future medical needs, including nursing home or rehabilitation facility placement.

Although both Medicaid and Medicare are federal health care programs, Medicaid is actually overseen by each individual state. Medicaid eligibility is geared more towards people who are low-income; however, Medicare qualification is for everyone, regardless of income.

To qualify for Medicare, a person must be 65 years or older, or a beneficiary of the Social Security Disability Insurance (SSDI) program for a minimum of two years. The program pays for physician visits, lab costs, outpatient care and supplies, prescription medicines, and hospital stays. The program will also pay for short-term nursing home stays (i.e. rehabilitative services) for stays up to 100 days. Hospice services are also covered by Medicare for those who have been given less than six months to live.

The price to enroll in Medicare is based on the plan in which a person enrolls, and all three plans have yearly deductibles. Typically, an enrolled senior is responsible for 20 to 35 percent of their health care costs and is again dependent on the plan in which they are enrolled

In Illinois, the Medicaid program is run by the Illinois Department of Healthcare and Family Services (DHS) and qualification is based on income. Medicaid programs pay basic health care services, such as doctor visits and all of the same coverage that Medicare covers; however, the program will additionally pay for a majority of long-term nursing home costs, assisted living, or at-home health care costs. Also, Medicaid will cover the price of prescription medications that a person's Medicare coverage does not.

Medicaid enrollment costs are often free or of minimal charge and can cover an insured Medicare's deductible, as well as the percentage of medical costs that Medicare does not pay.

One of the greatest expenses facing seniors is the cost of nursing home care and those costs can typically eat up the majority of a person's life savings if the appropriate financial plans have not been put into place beforehand. To make sure that does not happen to you, please contact an experience DuPage County estate planning attorney to help protect your family's financial future.