Understanding Medicare & Medicaid for Healthcare and Long-Term Care

The Medicare & Medicaid 101 Hub

Medicare and Medicaid are two of the most important government programs providing healthcare coverage in the U.S., yet many people are confused about who qualifies, what they cover, and how they affect long-term care and estate planning.

This hub provides a high-level overview of Medicare vs. Medicaid, eligibility, coverage, and key considerations for estate and long-term care planning. Whether you are planning for yourself or helping a loved one, understanding these programs is essential for making informed healthcare and financial decisions.

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Key Things To Know

Medicare and Medicaid serve different purposes but sometimes work together for those who qualify for both.

  • Medicare is a federal program primarily for people 65+ and those with disabilities. It provides health insurance coverage but does not typically cover long-term care in nursing homes.
  • Medicaid is a state and federal program for low-income individuals that covers more services, including long-term nursing home care.
  • Medicare has multiple parts (A, B, C, and D), each covering different healthcare needs.
  • Medicaid eligibility varies by state. Income and asset limits determine qualification, which is important for estate planning.
  • Many people use Medicaid for long-term care planning. Medicaid planning strategies can help protect assets while ensuring eligibility for benefits.
  • You may qualify for both programs. If you are low-income and 65+ or disabled, you may receive both Medicare and Medicaid benefits (dual eligibility).

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Frequently Asked Questions

Healthcare costs can be overwhelming, especially when planning for aging or long-term care. Knowing what Medicare and Medicaid cover can help you prepare for medical expenses and protect your estate.

  • Medicare is a federal health insurance program for people 65 and older or with certain disabilities. It does not cover long-term nursing home care.
  • Medicaid is a state and federal assistance program for low-income individuals of all ages. It does cover long-term nursing home care for those who qualify.
  • Medicare Part A: Covers hospital stays, skilled nursing care, and hospice (but not long-term care).
  • Medicare Part B: Covers doctor visits, outpatient care, and preventive services.
  • Medicare Part C (Medicare Advantage): Private insurance plans that bundle Parts A and B, often with extra benefits.
  • Medicare Part D: Covers prescription drug costs.

No. Medicare only covers short-term skilled nursing care (up to 100 days) after a hospital stay. It does not pay for long-term care in a nursing home or assisted living.

To qualify for Medicaid long-term care benefits, you must meet income and asset limits that vary by state. Some assets, like a primary residence, may be exempt.

Yes. If you qualify for both programs (dual eligibility), Medicaid can cover expenses Medicare does not, such as long-term care and additional medical costs.

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Disclaimer: The information provided on this website and by Buried in Work is for general informational purposes only and should not be considered legal advice. Please consult with a qualified attorney or subject matter expert for advice specific to your situation.