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Incorporating Medicare and Medicaid into long-term care plans

On Behalf of | Aug 16, 2024 | Elder Law

Planning for long-term care in New York can feel overwhelming, but understanding how Medicaid and Medicare play a role might ease your concerns. These two programs offer different types of support as you age or face health challenges. Understanding this can help you prepare effectively for the future.

Understanding Medicare’s role in long-term care

Medicare is a federal program that primarily helps people aged 65 and over cover some healthcare costs. When it comes to long-term care, Medicare offers limited assistance. It mainly covers short-term medical needs.

For instance, if you need skilled nursing care following a hospital stay, Medicare might cover this for a limited time. Typically, it will cover up to 100 days of skilled nursing facility care per illness, provided certain conditions are met. After that, you’re responsible for all costs.

Medicare does not pay for non-medical, long-term care services such as assisting with daily bathing and dressing. They consider these custodial rather than medical needs.

How Medicaid supports long-term care needs

Unlike Medicare, Medicaid is a state and federally-funded program that provides more comprehensive help, including long-term care for those who qualify. In New York, Medicaid covers costs that Medicare does not, such as long-term custodial care in nursing homes and some home health services.

Medicaid also covers home and community-based services, allowing many to receive care in their homes or communities rather than in nursing facilities. 

Eligibility for Medicaid depends on your income and assets. It’s designed for individuals with limited income and resources. If you think you might need Medicaid to help with long-term care in the future, planning ahead is crucial.

Remember, while Medicare covers some short-term needs, Medicaid is likely your go-to resource for extended care as you age, especially if your resources are limited. Preparing early, understanding your options, and planning for potential healthcare needs are vital steps in ensuring you receive the care you need in later years.

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