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Medicare or Medicaid?

Jason A. Penrod, B.C.S., CELA

In my career, I venture that Medicare and Medicaid are the two government programs that are families confuse the most.  In other words, many people will refer to Medicare and Medicaid as though they are one in the same or will mistakenly refer to the wrong program.

When former President Donald Trump was known for being a wealthy businessman and television star of the show “The Apprentice” rather than as the 45th President, I frequently used him to demonstrate the main difference between Medicare and Medicaid.  I simply would state: 

Donald Trump may receive Medicare, but he will never receive Medicaid.

While both Medicare and Medicaid both help people pay for medical care, Medicaid is a needs-based program.  In other words, applicants need to financially qualify to receive Medicaid benefits.  Meanwhile, the amount of Medicare beneficiaries’ income or assets is irrelevant to their being enrolled in Medicare.

Another difference is how the programs operate and are funded.  Original Medicare, also referred to as Traditional Medicare, is administered by the federal government to provide healthcare to those 65 year of age or older as well as people receiving Social Security Disability.  On the other hand, Medicaid is a joint federal-state program for which states receive funding by administering eligibility criteria within mandated federal guidelines.  Thus, Medicare rules are uniform while Medicaid qualification rules vary from state to state.

Nursing home care coverage is also an area of misunderstanding.  While Medicare may provide for nursing home care coverage, it does so within a relatively short time frame.  In fact, coverage is limited to acute rehabilitative care and will only assist with nursing home care expenses for a maximum of 100 days and Medicare Advantage plans often pay for an even shorter duration.

Medicaid covers all types of medical care, including nursing home care.  However, eligibility criteria are more stringent for having Medicaid pay for nursing home care.  But there are ways to astutely position your income and assets to receive Medicaid assistance.

Since this is a specialized area, contacting an Elder Law Attorney (preferably one that is board certified) is highly advisable.  By establishing a comprehensive financial plan, and having the comfort of using an expert, your family can be prepared for nursing home costs which average $10,000 per month in the state of Florida.

Jason A. Penrod is only the 20th attorney to be Board Certified as an Elder Law Expert by the Florida Bar and the National Elder Law Foundation. He is an active member of the Life Care Planning Law Firms Association and is the founder of Family Elder Law (www.familyelderlaw.com) which has offices in Lakeland, Lake Wales, and Sebring, Florida.

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