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Medicare is a federal government program that provides medical insurance for payment of expenses related to acute medical care and rehabilitation from short-term illnesses and injuries. Medicaid is a joint federal, state and local program that provides a broad range of medical and health benefits, including long-term care for those who are permanently ill, injured or disabled. The two programs are very different as to coverage, rules, and eligibility. Also, Medicare is essentially the same nationwide, but Medicaid differs, often significantly, from state to state.

You qualify for Medicare benefits at age 65 or older if you are a U.S. citizen or are a permanent legal resident, and you or your spouse has worked long enough (usually 10 years or more) to be eligible for Social Security retirement benefits. Your payroll deductions cover Part A (hospital), but you must pay a monthly premium for Part B (doctors) or Part D (drugs). You’ll also pay a premium if you decide to join a Medicare Advantage (Part C) plan, which typically covers all of your medical care on an in network basis. Medicare is medical insurance. It does not cover long-term care. The only program that covers home care, assisted living, or nursing home care, is Medicaid.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

These are common misconceptions about Medicaid. Almost everyone can qualify for Medicaid with appropriate Elder Law planning. Click here to Find Your Situation.

There is no requirement that you retain an attorney to prepare your Medicaid application. However, most people find that completing the application is a daunting and confusing task. When you prepare your own application, you risk doing it incorrectly, and making errors that may ultimately compromise or delay your eligibility for benefits. When an experienced Elder Law firm handles your application, you can be confident that it will be approved, and you’ll save yourself a lot of aggravation in the process. Also, before filing your Medicaid application, your attorney will have protected your assets and income to the extent legally permissible, and have put you and your family in the best possible position going forward.

You may see advertisements or solicitations from independent paralegals, social workers, or geriatric care managers, that they can handle your Medicaid application for a lower fee than a law firm would charge. However, none of them are qualified to give you legal advice about the steps you can properly take to obtain Medicaid eligibility, or about how you can protect your assets or income at the same time.

Yes, you can. In most cases, it makes sense to keep both, as you will have access to a greater choice of doctors and other medical providers.

In some counties of New York State, you may be encouraged to join (or be passively enrolled in) a FIDA plan that delivers both Medicare and Medicaid services on an in network basis. FIDA stands for “Fully Integrated Duals Advantage,” referring to people who are eligible for both Medicare and Medicaid. As long as you have the right to keep traditional Medicare, you may want to seek advice before enrolling in a FIDA plan.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

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