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MEDICARE |
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MEDICAID |
| 1. |
Federally funded government health insurance program for people 65 and over for those on Social Security Disability. |
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1. |
Funded jointly by the Federal government and individual states. Individuals must meet specific financial criteria
for income and assets. |
| 2. |
Qualification based on age and/or disability. Participation not subject to income, asset or "needs" test. |
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2. |
Qualification based on financial need. Single individuals are limited to assets under $2,000 in most states.
Married couples are limited to $4,000. |
| 3. |
Provides coverage for hospitalization, doctors, and other types of medical expenses. Has new prescription benefit
under Part D. Medicare is a medical insurance program except for a limited short-term nursing home benefit for skilled care, it is not coverage for long-term care. |
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3. |
Provides benefits for long-term nursing home care, and, in many states, benefits for other types of long-term care. |
| 4. |
In order to get Medicare coverage for a nursing home stay, you must be in an approved skilled nursing facility,
have been in the hospital for at least three days prior to entering the facility, and to be deemed by Medicare to
be medically benefitting from that skilled nursing care. Custodial care is not covered. Technically, there is a
maximum 100 days of nursing home benefit. Days 1-20 at full benefit; days 21-100 with a daily co-payment amount ($133.50 in 2009) |
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4. |
Those individuals who meet the definition of "need for care", as well as the financial requirements, can qualify
for nursing home care (including custodial care). There is no maximum limit on the period of time that care can be provided. |
| 5. |
Under no conditions does Medicare pay for assisted living, residential care facilities and adult foster care. |
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5. |
In some states, Medicaid will provide care in assisted living, residential care and/or adult foster care facilities. |
| 6. |
Medicare Part D covers prescription benefits. |
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6. |
Medications excluded from the Medicare formulary may be covered. |
| 7. |
Medicare does have some benefit for home health, but this is purely for medical reasons, not for caregivers to come in and attend to someone who needs help with personal needs on a long-term basis. |
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7. |
In many states, in-home care is provided to allow for caregivers to come into the home to provide care and help with personal needs and activities of daily living. |
