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Determining Which Is Right For You Between Medicaid & Long-Term Care

Chris Antrim • May 10, 2023

Which Coverage Will Suit For Your Needs & Wants? Understanding Medicaid & Long-Term Care

The most misunderstood aspects of Medicaid are it is long-term care benefits. Many enrollees are unaware of this plan, that is why they tend to choose plans without the care they want or need.


Before you decide on the plan you’re going to choose that will cover your long-term care needs, it is necessary to understand its components and how this differs from long-term care insurance.


This introduction will provide an overview of Medicaid and long-term care, including the services covered, eligibility criteria, and ways to access these services. Whether you are a caregiver or a person in need of long-term care, this guide will help you navigate the complex world of Medicaid and long-term care to make informed decisions about your healthcare and personal care needs.

What Is A Medicaid?

We all know that Medicaid is a program designed to provide various healthcare needs and custodial services for some people who cannot afford it or have limited income and resources. Medicare long-term care is a great benefit for those who don’t have much income for their retirement or needs more care aside from what their families can provide.


However, some people decided not to bu
y long-term care insurance and just rely on Medicaid instead. Unfortunately, many people found out that the Medicaid they acquire does not offer what they really want and which is a little too late. The components you want such as benefits and coverage options are provided by long-term care insurance itself.


What Is A Long-Term Care Insurance

While long-term care insurance is coverage that offers all parts of nursing-home care, home healthcare, and personal or adult daycare for U.S residents aged 65 or older with a chronic condition that needs continuous care. Long-term care insurance is available at private insurance and to anyone who can afford to pay for it. This coverage offers more flexibility and options than Medicaid. The good thing about this is because you’re the one paying for this, there are no income and asset limits.


Here are the key differences between Medicaid and long-term care insurance.

Benefits & Coverages Medicaid Long-Term Care
Nursing Homestays Usually covers. Usually covers.
Coverage from the first day in a nursing facility Usually covers. You may experience some policies that may have a waiting period.
A nursing home stay as long as it Needs Usually covers. It is too expensive, the plan rarely offers this
Coverage for any nursing home Some facilities do not accept Medicaid. Usually covers.
In-home care Coverage may differ from every state, not many states cover this. Available options.
Adult day-care Rarely. Available options.
Assisted living facility Not available in most states. Available options.
Access to all services in a nursing facility Not allowed to visit private or spousal rooms, trips, shopping, and personal care. If you need more extra services, your family must pay extra for these services. Access to private or spousal rooms, trips, personal care, and whatever a certain policy covers.
Choosing of facility The only reasons you can move a facility are if the facility stops accepting Medicaid or it becomes full. Yes, as long as the facility is open and available. In addition, you can decide to move freely at your own will

As you can see there are several differences between these two. Medicaid offers limited access to your wants and needs. While the long-term care since you’re the one paying it you have all the flexibility and access to all coverage as long as you keep paying for these services. Before applying for a plan make sure you understand how it works and the components on it. It is best to ask an agent to get a full idea about this, or they even give you a better suggestion on what is right for your needs. 


Eligibility Criteria For Medicaid & Long-Term Care

Medicaid is a government-funded health care program that helps people and families with low incomes and few means get coverage. People who can't take care of themselves because of a long-term illness, disability, or mental illness can also get long-term care through the program. People and families who may need help with their health care and personal care needs should know how to qualify for Medicaid and long-term care.


Eligibility for Medicaid

People must meet certain income and asset standards in order to get Medicaid. Different states have different limits on income and assets, but in general, Medicaid is for people whose incomes are at or below the federal poverty level (FPL). The FPL is a standard for income that the federal government sets each year to decide who can get help from different programs.


Medicaid has limits on both how much you can earn and how much you can own. Things like savings accounts, investments, and land are all examples of assets. The limits on assets also change from state to state, but in general, a person can't get Medicaid if they have more than a certain amount of assets. But some assets, like a main residence, may not count toward the limit.


Eligibility for Long-Term Care

People must meet the requirements for their state's Medicaid program in order to get long-term care services through Medicaid. A healthcare professional must also decide that a person needs a certain amount of care, in addition to meeting income and asset requirements.


Medicaid usually pays for two types of long-term care: care in a hospital and care at Home & Community Based Services (HCBS). Institutional care is care that is given in a nursing home or other facility, while HCBS is care that is given in the person's home or neighborhood.


Institutional care is usually only for people who have a lot of care needs, like needing help with multiple activities of daily living (ADLs) like bathing, dressing, and eating. Each state has different rules about who can get HCBS, but in general, people must need a certain amount of care and meet income and asset requirements.


How To Get Medicaid and Long-Term Care Insurance

People must apply through their state's Medicaid program to get Medicaid and long-term care benefits. During the application process, people may have to show proof of their income, assets, and other details. Once someone is accepted for Medicaid, they can get a variety of health care and long-term care services.


There are other programs and tools besides Medicaid that can help people get long-term care services. These include Medicare, benefits for veterans, and private long-term care insurance. It is important to look into all available choices and resources to make sure that people get the care and help they need.


Get Help with Your Choices - Contact Chris Antrim Insurance

Medicaid is a joint federal and state program that provides healthcare coverage and long-term care services for eligible low-income individuals and families. Long-term care refers to a range of services and supports that help meet personal care needs for people who are unable to care for themselves due to a chronic illness, disability, or cognitive impairment.


Understanding Medicaid and long-term care is important for individuals and families who may need assistance with healthcare and personal care needs as they age or face a disability. With the rising costs of healthcare and long-term care services, it is crucial to know the eligibility requirements, coverage options, and benefits of Medicaid and other programs that provide long-term care support. To help you get the best support and help you make the right decision between the two choices, get in touch with Chris Antrim Insurance for all your question and inquiries.

Thank You For Reading!

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