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Medicare v. Medicaid: What’s the Difference?

Medicare v. Medicaid: What’s the Difference and how will it affect you and your family?

Many people ask: Do I need to spend everything before getting help to avoid nursing home poverty? Not if you plan in advance!

Medicare and Medicaid: They sound alike, don’t they?  Too many people don’t recognize the difference between the two, especially in the area of long-term care expenses.  If you are relying on Medicare to pay a nursing home bill you may be in for a shock.

What is Medicare? Medicare is the federal health insurance program provided on behalf of people who are over the age of 65, blind, and/or disabled. Medicare is designed to cover short-term or “acute care” health care, that is illness from which you could get well!  If you are diagnosed with Alzheimer’s, Parkinson’s, dementia, or anything else that means a long nursing home stay, you will not be covered.

What WON’T Medicare Do? Medicare does not provide any benefits for what is called ‘custodial care’ or long term care benefits (nursing home care, for instance). If you meet some very specific qualifications, Medicare may cover some portion of the first 100 days of a nursing home stay, but after that you and your family are on your own! Few people realize the limitations on what Medicare will and won’t cover-which winds up costing them a substantial loss of dignity if or when they get hit with long term care expenses.

Avoid Nursing Home Poverty

What is Medicaid? Medicaid (MassHealth) is a separate, health care program that pays for 50% of the nursing home care in America today. Once you become sufficiently impoverished, then Medicaid is designed to provide care for you. That means if you need a nursing home, haven’t done any planning, and you are not impoverished, you are on your own dime! However, to qualify for Medicaid nursing home benefits you must be very ill and have no more than $2,000 total assets if you are single, widowed or divorced or $109,000 for a married couple.

Does that mean you need to spend everything you have before getting any help for you and your family? Not if you plan in advance!

Our Process:

At the Estate Planning and Asset Protection Law Center of Dennis Sullivan & Associates we help our clients plan to avoid nursing home poverty and protect themselves through a process that combines education and counseling. The process begins with an educational Trust, Estate and Asset Protection Workshop, held twice a month in Wellesley (for upcoming dates and to register, please visit us at  The workshops are an excellent way to review existing planning, if any, and learn how to avoid nursing home poverty by proactive planning to protect yourself, your spouse, your home, life savings and legacy.  We welcome all members of the community to attend. For those that cannot attend, please contact our office directly or review our free elder law resources.