I don't know. A young woman shrugging with question marks.

Top 5 Things to know about Medicare Vs. Medicaid when thinking about Senior Care

Top 5 Things to know about Medicare Vs. Medicaid when thinking about Senior Care;

through the eyes of a Wisconsin-Based Senior Care Advisor…

As a Senior Care Advisor based out of Appleton, Wisconsin, I find that many of my senior clients and their families are unclear about the differences between Medicare and Medicaid. While my expertise of these programs is basic, I am knowledgeable on how they work in relation to the people my team and I at CarePatrol serve; those who are needing support with their daily activities and/or personal cares. They are considering assisted living or home care, or they are wrapping up a rehab in a skilled facility and are unsure about next steps. In an attempt to clear up some of the misunderstandings of what insurance will and will not cover, I wrote up 5 basic things that I wish every family understood about Medicare and Medicaid.

  1. Medicare is the government-sponsored health insurance available to senior citizens who qualify based on their age and to others based on their disability. Just like private insurance, this is health care coverage. There are some wellness benefits and some acute care benefits.
  2. Medicaid is government – sponsored insurance designed as a safety net for those who are unable to afford other insurance coverage or who have significant ongoing care needs that are not covered by health insurance, and the person does not have more than $2,000/$3,000 in assets (excluding the home in which they live and 1 car).
  3. Medicare will pay for short-term rehabilitation in a skilled care nursing home. This most commonly follows an acute care hospitalization to trigger an authorization by Medicare. A short-term rehab can last from 7-120 days. Most Medicare insurance providers will quote the 120 days of eligibility, but in reality most people we see are granted about 2-3 weeks of rehabilitation in a skilled facility.
  4. Medicaid is a wonderful safety net to ensure that nearly all American’s can receive the care that they need. However, the providers who accept Medicaid are limited, and those who do accept often limit the number of people who are on Medicaid due to the relatively low reimbursement rates.
  5. All seniors, whether on Medicare or Medicaid will have options for their medical and their long-term care. However, just like in our everyday lives, those with the best coverage and ability to pay with personal funds/equity will have access to the most and the best quality care options.

Do you have questions about long-term care and how to pay for it? Call your Fox Cities CarePatrol Senor Advisor team at 920-428-0827 carepatrol.com