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Medicare vs. Medicaid and The Rise of Alzheimer’s Disease

Do you know the difference between Medicare and Medicaid?  For ANY senior it is vital to know the difference.  Your future may depend on it, particularly with the new statistics regarding Alzheimer’s Disease and other incurable, long-term care illnesses.

According to the World Alzheimer Report 2010, Alzheimer’s Disease is taking a terrible toll on the world – not to mention on individual families and their life savings.  With no cure on the horizon, the problem is only expected to get worse.

According to Dr. Daisy Acosta of Alzheimer’s Disease International, “This is a wake-up call that Alzheimer’s disease and other dementias are the single most significant health and social crisis of the 21st century.”

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What’s even worse is that dementia is on the rise, and in the US almost half the seniors over age 80 have this tragic disease.  For more information about what you can do to make your life as a caregiver better today, read our free Alzheimer’s Resource Guide, or call our office for options about how to pay for care.

So what does this have to do with Medicare & Medicaid?

Medicare provides health care benefits for people over 65, the blind, and the disabled; while Medicaid provides medical benefits for the poor.

Medicare is mainly a type of public health insurance for those age 65 and older. It is their primary health insurance coverage. Many seniors do not realize that Medicare does not pay for long-term care.  Actually, it is excluded! The confusion is easy to understand because Medicare does pay for rehabilitation. So, if a senior citizen is enrolled in the traditional Medicare plan and is hospitalized for a stay of at least three days, and is then admitted into a skilled nursing facility, Medicare may pay – for a short while. But once those Medicare benefits hit 100 consecutive days, you’ve hit the maximum.

In some cases, Medicare may not even cover the full 100 days. There must be some actual improvement in your condition, otherwise Medicare will decide that it is a long-term care need, and they’ll cut you off. Medicare really only cares about you if you can get better. Since diseases like Alzheimer’s and Parkinson’s have no known cure today, rehabilitation is not possible, so Medicare will not pay for nursing home care if you have Alzheimer’s or Parkinson’s.

Unlike Medicare, Medicaid will pay for Alzheimer’s, Parkinson’s, or dementia-related diseases or a decline in functioning due to the aging process. You must, however, exhaust all your resources (including your spouse’s as well) first before you will be eligible.  Medicaid, however, is paid for by both federal and state funds but is “administered” on a state level. The federal government covers between 50-80% of the program costs within the state, and the state pays the rest. Therefore, rules can vary from state to state (even county to county) rather dramatically.  Also, the law enables you to take steps to protect your home, life-savings and spouse so they are not impoverished if you go to a nursing home.

So, as you can see, Medicare is health insurance, and Medicaid is public long-term care coverage, but often there are stages in between that require examination and discussion.  For more information, download our free elder guide The Massachusetts Elder Guide to Medicaid, Nursing Homes and Asset Protection or watch Dennis Sullivan being interviewed about how to avoid nursing home poverty on the national talk show, “Ask The Lawyer.”

To learn more about your options, call us at (781) 237-2815; (800) 964-4295 (24/7) or register online to attend one of our free workshops.  You need to be informed about your particular situation and for that you’ll need some honest, legal strategies to protect yourself, your spouse, and your hard-earned assets for the future.