Download Free Special Report for Seniors, the Disabled, and Their Families

What’s the difference between
Medicare and Medicaid?

Share

4. Understand the difference between Medicare and Medicaid.
These are both medical and health programs provided by government entities to pay benefits to senior citizens and the disabled. That's where the similarity ends. They're completely different, and each has its own rules and regulations. Many people confuse the two, but their functions are quite distinct.

Medicare is medical insurance for seniors and the disabled. It's just like any other medical insurance policy, except that the federal government provides it. It pays expenses related to short-term illness or injury, acute care and rehabilitation.

Medicaid is a federal, state and locally funded program. ln addition to covering medical services, it provides benefits for those needing long-term, custodial care, who are permanently ill, injured or disabled, and financially eligible. Medicaid will assist people who have difficulties with the "activities of daily living," such as bathing, dressing, eating, and going to the toilet, as well as those who need skilled nursing care. Medicaid also covers most medical expenses that are not covered by Medicare or other insurance.

A major benefit of being approved for Medicaid is that it will pay for long term care expenses that Medicare doesn't cover. You may also gain access to additional services, such as adult day care.

For example, Lamson & Cutner represented a single, middle-aged man suffering from traumatic brain injury. We shifted his excess income to a protective trust, so that it could still be used to pay his living expenses. He qualified to receive Medicaid benefits, and to be placed on the Traumatic Brain Injury Waiver Program list, which provides extra services for his special needs.

So remember: Your medical insurance is for acute medical needs and rehabilitation only. ln our experience, a significant number of people assume that their Medicare or other medical insurance will cover the cost of their long-term care, which is entirely incorrect. Also, while Medicare and supplemental insurance provide "up to 100 days" of coverage for rehabilitation from a given injury or illness, actual coverage may be far less if rehabilitation is achieved earlier, or you are not making progress. Many patients are surprised to find themselves obligated for large out-of-pocket costs for care following an illness or injury. This can easily happen when you have no more "Medicare days," but are not ready to resume your former lifestyle, and need continuing care.

Table of Contents

25 Strategies to Prevent Financial Ruin
from Long-Term Health Care Costs

Copyright © Lamson & Cutner, P.C., 2009, 2010, 2011 All Rights Reserved

Download Free Special Report PDF

Special Report Disclaimer