Family Health Legal Library

Medicaid - What If This System Is Necessary

Am I Prepared To Understand The Application of Medicaid?

Medicaid is a program that is different from Medicare, because it has certain specific eligibility requirements. Unlike Medicare, Medicaid focuses directly on healthcare for lower income Americans. It is critical for most Americans to understand this area, however, because of the possibility that services not covered under Medicare, with its substantial coverage limits, may be covered under Medicaid.

One of the most common, and perhaps difficult, questions that attorneys receive who practice in the elder law area is what happens when Medicare will not cover a patient's medical problem as it needs to be covered. For example, what happens when people suffer from Alzheimer's and require extensive treatment and care in an institutional setting? While this care can initially be provided under Medicare, additional coverage for lengthy stays and care beyond the limits of Medicare may be contemplated. In this situation, many middle and upper middle income people are seriously forced to examine the rules and regulations of Medicaid as a means of assistance for their ailing parent or parents.

If they were forced to pay for the care of their ailing parent, the estate of the parent [including some of the estate of the non-ailing parent, if alive] may be required to be used as a resource to pay for medical care. Additionally, persons making these decisions can face the heart-wrenching decision of whether to spend their own family resources for the care of a parent, and possibly deprive a child of a college education. We have seen situations in which estates of $200,000 or $300,000 have been depleted in extremely short periods of time by medical expenses, leaving one's elder parents destitute, despite hard work and honest savings throughout their lives.

For these reasons, a complete discussion of this area is included here. If you have older parents, you might consider purchasing a great Medicare Supplement package to assist with insurance coverage in the event longer stays or more coverage than that covered by Medicare is necessary. This, in some instances, can help avoid invoking the Medicaid system, with its onerous requirements, as we discuss in some detail here.

Medicaid - What If This System Is Necessary
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