I have Medicare; is that the same as long term care Medicaid and will it cover my nursing home costs?
Medicare and long term care Medicaid are two very different programs that cover different things. Let’s review what each program covers and does not when it comes to nursing home costs.
Medicare consists of two parts Part A and Part B. You can also purchase private Medicare Supplement, Medicare Advantage, and Part D (Prescription Drug) plans that include additional benefits and reduced cost-sharing (copays, coinsurance, deductibles). In most cases, to qualify for Medicare, you must be 65 years old. However, there are some other ways to qualify, including permanent disability.
Medicare Part A (hospital insurance) covers Medicare in-patient care received while in a hospital, skilled nursing facility, and, in certain circumstances, at-home treatment.
Medicare Part B (medical insurance) covers medical services provided by doctors, nurses, and other health care professionals. Part B coverage includes outpatient care, ambulance services, preventive services, and durable medical equipment. It also covers part-time home care and rehabilitative services, including physical therapy.
Medicare does NOT cover long-term nursing home or in-home care.
Long term care Medicaid
Like Medicare, long-term care Medicaid provides comprehensive in-patient health care coverage, including services and costs associated with nursing facilities and rehabilitation facilities. To qualify for long-term care Medicaid, you must meet specific criteria that differ from state to state, and the rules are incredibly complex. They are generally based on meeting certain income and asset limits as well as care needs. This is different from Medicare which generally uses age as the primary qualifying criteria.
Long-term care Medicaid CAN cover long-term nursing home or in-home care provided you meet the criteria for needing long-term care.