The Differences Between Medicare and Medicaid

attorney long-term care medicaid medicare nursing home Nov 25, 2016











The Facts...


Medicare is a health-care benefit provided by the federal government to individuals over age 65, or under age 65 and disabled. Medicare covers doctor visits, tests and care provided in a hospital   and limited benefits in a nursing home (see below). 

Medicaid is a health-care benefit provided by the federal government for people under certain asset and income limits.  With nursing home care costs between $70,000 - $100,000/year, even people that consider themselves relatively comfortable financially may eventually need this important benefit. If your income or assets exceed the qualifying limits, you will not be eligible, but with proper planning, you can be. There is no age restriction to qualify.

Learn more about the differences between Medicaid and Medicare - read here. 


To qualify for Medicare, you must be over 65, and eligible for Social Security benefits. You may also qualify if you are under age 65 and disabled for two years. An application at the Social Security office will get your benefits started. 

To qualify for Medicaid, you must submit a multiple-page application and provide detail proof of all your financial transactions (banking, CD's, stocks, bonds, income, expenses, annuities, etc.) for the previous 60 months

Nursing Home Costs

Medicare will only pay for 20 days in a nursing home (in limited circumstances, it can pay partial cost of 80 additional days) while Medicaid will pay the entire cost of a nursing home.

The laws around Medicaid qualification are extensive, and there are many exceptions. Often, hospitals and nursing homes will offer to do this for you at no cost. Be careful, they do not represent you, but rather, the institution for which they work. Even with the best intentions, they often do not have the legal knowledge necessary to determine whether or not your qualification is accurate, or how to protect the maximum amount of assets you have. This is where a legal professional can really be of value and often times, be able to get you benefits much sooner.

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This article regarding Medicare and Medicaid by Michigan lawyer Nicole Wipp and the Family & Aging Law Center PLLC is not, and should not be construed as, legal advice. It is for general informational purposes only. To better understand how this legal concept can be applied to you, consult with an attorney.