Although Medicare and Medicaid were signed into law in 1965, there continues to be a considerable degree of confusion around the programs and their respective eligibility requirements. It’s often not until faced with the reality and expense of paying for long-term care that many of us start to research the options available to us.
According to statistics from the U.S. Department of Health and Human Services, the average American turning 65 today will incur around $138,000 in future long-term care costs. Facing these steep costs, many seniors rely on financial assistance programs such as Medicare and Medicaid to help them afford their senior care.
As part of VOYCE’s Community Education Series we invited financial and legal experts Kevin Mason and Kurt Sergiewich to help us in navigating Medicare and Medicaid.
Kevin Mason is an attorney at TuckerAllen, a St. Louis based law firm that specializes in elder law, long-term care planning, Medicaid planning, and special needs planning.
Independent Financial advisor Kurt Sergiewich works closely with Wealth Protection Advisors, a company that specializes in asset protection and long-term care planning strategies.
MEDICAID
Kevin Mason: “We all know that long-term care can be very draining on resources, and that’s why we have this program, Medicaid, that can step in and assist if needed.”
ELIGIBILITY FOR MEDICAID
There are strict citizenship, medical eligibility, and financial eligibility restrictions for those who would like to apply for Medicaid.
To be financially eligible for Medicaid, an individual must be below certain income requirements. Some eligibility groups are limited by age, or by pregnancy or parenting status. Applicants must own assets of less than $5000 if they are a single individual or less than $10,000 if they are part of a married couple.
The State is highly competent at auditing your finances and assets. Asset Transfers, Exempt Transfers, and gifts must all be within the confines of the law. When you apply for Medicaid benefits, there is a 5-year look-back period where the state audits your finances and examines your assets for the purposes of avoiding fraud. It’s important to work closely with an attorney or financial advisor who can ensure that you follow best practices with your finances.”
MEDICARE
Independent Financial Advisor Kurt Sergiewich gave an informative presentation on Medicare, exploring eligibility and debunking some of the myths around Medicare.
WHAT IS MEDICARE?
Kurt Sergiewich: “Medicare is the federal health care program for people 65 and over, and its coverage plays an important role in containing medical costs as you age. But Medicare benefits don’t pay for everything and is intended only for short-term use.”
“Both Medicare and Medicaid may include premiums, deductibles, copays, and coinsurance. For Medicare, how much you pay will vary based on when you enroll, selected coverage options, and what health services you use.”
Medicaid programs include federally mandated benefits and optional benefits. Each state decides what optional benefits to have.
KEY DIFFERENCES BETWEEN MEDICARE AND MEDICAID
A key difference between Medicare and Medicaid is that one is primarily age-based, and the other is an income-based welfare program benefiting people with limited financial resources, regardless of age.
Additionally, you can apply for Medicaid at any time your situation warrants it, and you do not have to wait for an open enrollment period. In most cases, people who qualify for Medicaid may be exempt from the individual penalty, whereas you may be penalized when you apply for Medicare outside the enrollment period.
LEARN MORE AND GET CONNECTED
Long-term care planning is a vital step as we prepare for the future and ensure peace of mind while caring for the ones we love. We recommend connecting with financial planning experts to explore the options and opportunities available for paying for long-term care and managing personal assets.
We are grateful to Kevin Mason and Kurt Sergiewich for joining us for our 2021 Community Education Series as we explored Navigating Medicaid and Medicare.
For more information on our guest speakers and their services please visit:
Kevin Mason, TuckerAllen: (314)-335-1100
Kurt Sergiewich: (636)-485-7843
VOYCE recently hosted a Community Education session on financing long-term care with valuable information on options and strategies for managing personal finances, assets, and estates. For more information, please see our recent blog post.