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Three Common Myths about Medicaid

Hand on a ChalkboardIn the state of Michigan, nearly 2.5 million people are provided health care under Medicaid. This includes low-income adults, children, senior citizens and people with disabilities that depend on the federal and state program for access to health care as well as long-term services which include basic life functions such as meal prep, bathing/dressing and administering medication. For those not familiar with the eligibility aspects of Medicaid, click here to view the video “An Introduction to Medicaid.”

However before you fill out those Medicaid enrollment forms, it is important to separate fact from fiction. The terms surrounding Medicaid are not always well-understood and common misconceptions often emerge. Below are three common myths about Medicaid along with the reality behind each one to provide you with more of an understanding of this program that assists millions of people with limited income and resources.

Myth #1: Those with retirement savings do not need Medicaid for long term services.

  • While saving for retirement should always be a part of everyone’s long term plan to be comfortable in their senior years, Medicare and private health insurance alone can fall short of covering long-term care expenses. If the cost of that care is not covered, often times Medicaid may become necessary for many middle-class income individuals. In order to receive Medicaid, you must meet the asset and income requirements which may cause these individuals to have to deplete a significant amount of the assets that they have saved. This trend will become more common if the cost of long-term care services continues to rise.
  • In 2018, the average daily cost of private room nursing home services in Michigan costs approximately $300. That works out to roughly $109,000 per year (or just over $9,000 per month) out-of-pocket. In-home care is generally more affordable than nursing home care, but the cost of even those services can consume nearly the entire income of the average older adult household if full time assistance becomes necessary. The average hourly cost for a licensed home health aide is around $20. Based on six hours a day, five days a week for 30 hours of care, that translates to $31,200 annually. Due to these high costs, Medicaid is a much-needed resource for seniors to assist with the long-term services they need.

Myth #2: Family caregivers can rely strictly on Medicaid without having to personally care for family members.

  • Over half of all U.S. adults, age 65 and older, will need some form of long-term services at some point in their lives. However less than one-fifth of senior long term service users will receive care provided by Medicaid. Family caregivers do take on much of the responsibility for providing the needed support for senior family members.
  • Most senior adults either pay for care out-of-pocket or through other means such as long-term care insurance. Often however they rely on family caregivers for help. Even when people enter a nursing home or assisted living facility, family caregivers still often continue to rely on the support from their friends and relatives. If you have a senior parent and are concerned about how they will pay for their care including Medicaid, read our previous post on “Helping my Aging Parents Pay for Care.”

Myth #3: The government pays for all expenses once you qualify for Medicaid.

  • While Medicaid can cover all of the living and medical expenses, Medicaid users that reside in nursing or assisted living homes may have to contribute a “patient pay” amount which can be nearly all of their income to pay for care, minus a small allowance for personal necessities such as clothing or toiletries. This is less than $100 a month in many cases.

It is important to check with experienced elder law counsel before attempting to navigate the complex legal checkpoints to qualify for Medicaid. For more information contact Matt Fedor at (248) 785-4734 or at mfedor@fosterswift.com.

Categories: Did you Know?, Elder Law, Long-Term Care, Medicaid Planning


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