Estate Planning & Elder Law Blog

A Beginner’s Guide to Medicaid Planning

Please note that the information in the following blog post is meant to act only as a general guide. Medicaid is an extremely complex area and varies based on the individual. Your questions need to be addressed by an attorney with significant experience in the area prior to taking any action.

As we age and begin to need more assistance, we often hear the terms 'Medicare' and 'Medicaid' used interchangeably, but they are different on a number of fronts. Medicare is a federal program funded through tax payers and is based on age, although special circumstances such as certain disabilities, allow younger people to qualify. Medicaid is managed by individual states so the elements in the program can vary by region. Eligibility for Medicaid is based on income and resources available to the individual.

Whereas with Medicare we become automatically eligible when we turn 65, Medicaid only sees a small percentage of adults age 65 and older enrolled in the program nationwide, about 9 percent. In fact, 43 percent of those enrolled in Medicaid are children. 

As of November 2020, over 72 million individuals are enrolled in Medicaid, according to medicaid.gov. The Medicaid program consists of several parts:

• Medical coverage through Medicaid includes most common forms of health care.
• Medicaid medical benefits cover at least the same health care services that Medicare does, as well as some services that Medicare doesn’t cover.
• Medicaid may also pay Medicare premiums, deductibles, and copayments for people who are enrolled in both programs.
• A separate part of Medicaid covers long-term nursing home care.
• Special Medicaid-funded programs cover long-term, in-home personal care.
• Income and asset eligibility rules for these long-term, at-home care programs are usually quite a bit looser than for regular Medicaid programs.
• In some states, a Medicaid-related program can pay some of the costs of assisted living:
  • Michigan has programs that offer payment for home health care services and nursing home costs, but does not offer Medicaid payments for most of the costs of an assisted living facility.

For more on the basics of Medicaid, see this guide from caring.com. The guide further explains some of the topics and addresses whether Medicaid may be an option for covering care-related expenses for seniors.

Among the topics/questions covered in the guide mentioned above include:

• How Does Medicaid Work?
• Is Medicaid Valuable for Someone who also has Medicare?
• How Much Income is Allowed for Medicaid Medical Coverage?
• What Kind of Medical Care is Covered by Medicaid?
• What Medicaid Does Not Cover
• Who’s Eligible For Medicaid?

Determining whether you’re eligible for Medicaid can be difficult, let alone figuring out what the program covers and how to apply. If you have further questions about Medicaid, long term care and other issues associated with aging adults, contact an elder law attorney. 

Categories: Elder Law, Medicaid Planning, Medicare/Medicaid