Long-term care expenses can be overwhelming, with the national median cost of nursing home care now exceeding $100,000 per year. Considering that people typically require between two and four years of care—and approximately 20 percent of those turning age 65 today will need long-term nursing care for more than five years—the total cost of long-term care can be staggering.
If you're running the numbers in your head and thinking that there's no way your family could shoulder that kind of financial burden, you're not alone. Many families need assistance covering nursing home costs, and government programs can help.
In fact, Medicaid is the primary payer for long-term care services in the United States. However, not only can qualifying for Medicaid be difficult but it's often confused with Medicare. Though the names are similar, these are two very different programs. Here's what you need to know.
Medicare vs. Medicaid
While both are government programs designed to provide access to healthcare, and it is possible to qualify for both, Medicare and Medicaid provide different benefits and are generally intended to serve different segments of the population.
Medicare
Medicare is a federal program that provides health care coverage to people age 65 and older who've paid into the system over the years via the payroll tax. The program serves people regardless of income and, in addition to seniors, serves younger individuals with disabilities, as well as dialysis and ALS patients. Medicare consists of four parts:
- Part A – Hospital Insurance
- Part B – Medical Insurance
- Part C – Medicare Advantage Plan
- Part D – Prescription Drug Coverage
Patients pay deductibles for various costs and a nominal monthly premium for non-hospital coverage.
Medicaid
Medicaid is a joint federal and state assistance program that provides a wide range of care and support services for people with limited incomes. It covers everything from routine medical care to major hospitalizations—and, importantly, long-term nursing home care. Most services are provided without charge; however, Virginia Medicaid does charge small co-payments for certain services.
Medicare Doesn't Cover Long-Term Nursing Care
Why would you need to qualify for Medicaid if you already have Medicare? Because, unlike Medicaid, Medicare doesn't cover the cost of long-term nursing care. While Medicare can cover inpatient care in a skilled nursing facility, it will only do so for up to 100 days and only if you meet certain other requirements.
Careful Planning Can Help You Qualify for Medicaid
Medicaid can cover long-term nursing home care costs. However, as a low-income assistance program, qualifying for coverage can be challenging. Medicaid has strict income and asset limits that may require you to "spend down" in order to reach eligibility. This is a tricky process that's rife with potential pitfalls. Giving away money and property to friends and family may sound like just the ticket, but it's a mistake that can cost you dearly. Medicaid has a five-year look-back period, and this is the surest way to run afoul of it, which could further delay your eligibility for much-needed coverage. Don't risk it. Professional help is available.
At Cucinelli Geiger, PC, our knowledgeable and experienced Virginia Medicaid planning attorneys can help you explore your options and find solutions to help you qualify. While the best time to tackle Medicaid planning tasks is well in advance of any long-term care need, it's never too late to protect your assets. Our experienced attorneys also offer crisis Medicaid planning services for when you find yourself facing an immediate or imminent need for extended nursing care.
Schedule a Consultation
Contact us today to schedule an appointment for a consultation to discuss your Medicaid planning needs with our skilled legal team. The sooner you reach out, the sooner we can get to work protecting everything you've worked for from the cost of a long-term nursing home.