Medicaid is one of the most intricate, confusing areas of the law, and I often think it is deliberately made so in an effort to maintain people from qualifying or to discourage them from trying to qualify. It is the authorities medical program for the poor.
Medicaid is usually confused with Medicare, which is the federal government medical program for the elderly. Virtually all senior citizens qualify for Medicare, as long as they have contributed to the system over their working lives. For these seniors who do not qualify, they have a chance to “purchase into” the system by paying premiums set by the federal government. Benefits under Medicare are limited; thus, seniors may purchase “Medigap” or Medicare supplement insurance insurance policies that pay benefits where Medicare leaves off.
Medicaid, on the other hand, is a joint program between the federal authorities and the states to provide medical care for the poor. As such, it is regulated first by Congress, then by state Legislatures. These lawmakers have set the standards by which Individuals and permanent residents (and only these courses of individuals, not “illegal aliens”, to dispel a rumor) can qualify for government-paid medical care. While qualifications can differ from state to state, there are a number of ideas that apply throughout-the-board.
Although Medicaid has programs for poor folks of all ages, my law observe concentrates on the elderly and those are the programs upon which I focus. Relying on the state, Medicaid can supply nursing dwelling care and/or at-residence care for seniors in need. Most individuals are aware of nursing dwelling care programs, however at-home care programs, in the event that they exist in your state, can provide an incredible different to nursing residence care. New York, for example, presents nursing residence care and also has an ambitious “group”, or at-house, Medicaid program; Florida, alternatively, presents nursing dwelling care and leaves it to the person counties to provide whatever type of at-residence care they can afford.
The program most people are aware of is nursing residence care, referred to in New York as “chronic care Medicaid” and referred to in Florida as “institutional care Medicaid”. If a person becomes so infirm that they can not perform sure Activities of Every day Living (ADLs), they’re unsafe dwelling at residence, they usually need medical help, they might want permanent nursing residence care. Contrary to popular belief, Medicare (the program for seniors) does NOT pay for nursing dwelling care; it only pays for limited “skilled nursing care”, which typically takes place in a nursing home with rehabilitation facilities. An excellent “Medigap” policy will pick up where Medicare leaves off, paying as much as 100 days in full for skilled nursing care.
If a senior wants permanent nursing dwelling care, nevertheless, they are both going to need to pay for it out of their own pocket, with lengthy-time period care insurance, or by qualifying for Medicaid. For many who can afford to pay for their own nursing residence care, kudos to you. For those who own or are contemplating purchasing long-time period care insurance policies, be a smart shopper: These policies usually pay a set each day rate (a fraction of the complete daily rate, particularly over time) for nursing residence care for a set time period (often only a few years), and incessantly do not go into impact till the individual is in the nursing house for so many days. You will need to read these policies carefully and understand them
The last option, Medicaid, is for the poor or those that have modest assets. Whether an infirm senior citizen will qualify for Medicaid to pay for nursing residence care is determined by whether they did advance Medicaid planning or whether their current financial standing immediately qualifies them. Typically a person has to “spend down” some of their property earlier than they qualify, although there are specific ways in which some assets might be shielded.
In the event you or your beloved is taken with studying more about Medicaid and proper planning for future qualification, make an appointment to see an elder lawyer who can overview your monetary picture and devise a strategy that can assist you meet your future needs.
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