Elder Law

Medicare vs. Medicaid

Many Americans mistake Medicare and Medicaid as the same programs that offer similar benefits.  Although both are government run programs, there are many important differences.  Medicare provides citizens, the disabled and blind with medical benefits.  Medicaid on the other hand provides healthcare benefits for those with little income.

Medicare is a public health insurance program for Americans who are over 65 years of age.  This program does not cover long-term acre, but can cover for certain rehabilitation treatments.  For example, if a Medicare patient is admitted to a hospital for at least three days and is subsequently admitted to a skilled nursing facility, Medicare may cover some of those charges.  However, Medicare payments for such care and treatment will no cover charges if the patient is there 100 days or if the patient stops improving.

Nursing home patients often find their Medicare payments are cut much sooner than the 100 days.  If a patient’s condition stops improving, Medicare coverage will be discontinued.  For example, many older Americans are suffering from diseases with no known cure, such as Parkinson’s or Alzheimer’s disease.   Consequently, it is simply implying that these patients be rehabilitated.  These patients are typically denied skilled facility coverage in these types of situations.

In summary:

  • Medicare provides health insurance for those aged 65 and over;
  • Medicare is regulated under federal law, and is applied throughout the United States;
  • Medicare pays for up to 100 days of care in a skilled nursing facility;
  • Medicare pays for hospital care and medically necessary services that will see improvement;
  • Medicare does not pay for long term care
  • To be eligible for Medicare, you generally must have paid into the Medicare system.

Overview of Medicaid

Medicaid is a state-run program, funded by both the federal and state governments.  Because Medicaid is administered by the state, the requirements and procedures vary across state lines, and you must research the law in your specific state.  The federal government’s issues Medicaid guidelines, but each state gets to determine how guidelines will be implemented.

In Summary:

  • Medicaid is a health care program based on financial need
  • Medicaid is regulated under state law, which varies from state to state;
  • Medicaid will cover long-term care.