While Medicare and Medicaid may sound similar, the two government programs are very different. For elderly residents of New York, Medicaid is a needs-based program intended to act as a safety net when they cannot afford to pay for their necessary health care or nursing home stays. However, the program is very complex, which is why many individuals find it beneficial to turn to a Long Island New York Medicaid planning attorney for guidance.
Even though Medicare is supposed to be an assistance program primarily aimed at individuals aged 65 and over, it covers only a small portion of the cost of nursing home stays and has many stipulations that must be met before a patient will receive even that coverage. Because of these requirements, elderly patients and their families often end up forced to pay for health care expenses out of pocket. At this point, many turn to Medicaid.
Medicaid is set up to require seniors to pass three tests before they are able to receive benefits. The first test is of medical necessity and requires proof that skilled nursing care is necessary to address the individual’s medical needs. Next is the asset test, which places strict limits on the property and possessions both a patient and spouse can own before he or she is allowed to receive benefits. There is also an income test, with an earnings cap on how much individuals and couples can make to still be eligible for Medicaid.
There are methods to circumvent these eligibility tests for elderly individuals who cannot pass but still need help paying for the cost of a nursing home stay. However, the process is generally best attempted with the help of a Long Island New York Medicaid planning attorney, as even a small error in the complicated process can mean refusal from the program. A lawyer with experience in elder law can help aging New York residents preserve assets while still qualifying for Medicaid.
Source: credit.com, “A Quick Guide to the Difference Between Medicaid & Medicare“, Brad Wiewel, May 17, 2017