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Medicare And Medicaid: Understanding Long-Term Care And Asset Protection


Older adults who need medical coverage may rely on both Medicare and Medicaid.  However, the two federal programs are quite different from one another. Medicare is a federal program that provides health coverage to older adults aged 65 and up, as well as to adults under the age of 65 if they have a documented disability. Medicare is not based on a person’s income level. Accordingly, even an older adult or a disabled adult who was a high earner prior to retirement or a disability, and who may have substantial retirement assets, can be eligible for Medicare coverage.  On the other hand, Medicaid is a need-based program that provides health coverage to low-income individuals and is typically managed by states. In many cases, older adults will receive both Medicare and Medicaid benefits, but eligibility for and use of these benefits can be quite different.

How do Medicare and Medicaid affect an older adult’s long-term care and asset protection planning? In short, planning for long-term care requires careful Medicaid planning. Our Westchester County asset protection attorneys can provide you with additional information.

Medicaid May Be Necessary for Long-Term Care, and You Should Plan Ahead to Protect Assets

Unless an older adult has substantial assets or long-term care insurance coverage that can pay for extended and costly care in a nursing home, that older adult will likely need to rely on Medicaid in New York State for this kind of coverage.  However, since Medicaid is a need-based program, older adults who need Medicaid to cover a stay at a nursing home will need to “spend down” their assets in order to qualify for coverage. Medicaid also has a “look back” period for determining when a person has transferred assets for purposes of becoming eligible for Medicaid. If you transfer assets too near to the date that you require Medicaid coverage, you can be penalized.

In order to ensure that you are eligible for long-term care through Medicaid without having to spend down assets, you should seek legal advice about your options from an elder law and asset protection lawyer. You can consider long-term care insurance as well as a Medicaid Asset Protection Trust and, if you qualify, a pooled income trust.

Asset Protection Plans Do Not Need to Involve Medicare

While Medicaid and Medicare sound alike in name, you should know that asset protection is not going to involve Medicare or vice versa. To be clear, if you are planning for long-term care coverage and protecting your assets, it is essential to understand that you will not likely be getting long-term care coverage through Medicare. To be sure, Medicare rarely pays for nursing home care, and even when it does, this coverage is temporary in nature. When it comes to long-term care planning and benefits, you need to plan with Medicaid in mind.

You should plan on Medicare for general health coverage if you are 65 or over, and on Medicaid (with appropriate planning) for long-term care coverage.

Contact Our Pleasantville and Mahopac Elder Law and Asset Protection Lawyers

If you have questions about asset protection and elder law in New York pertaining to Medicare and Medicaid, our asset protection attorneys can assist you. Contact Meyer & Spencer, PC to learn more.



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