Five Medicare and Medicaid Myths Uncovered

Jackie Bedard
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Have you fallen for some of these common Medicare and Medicaid myths?

Myth #1: Medicare Pays for Long-Term Care

Medicare is health insurance paid for by deductions taken from your salary during your working years. It covers expenses related to your health in order to make you well.  As such, it will cover the cost of a nursing home for a short time, however, as soon as you are deemed to have stopped improving, Medicare will stop paying for the nursing home. In addition, Medicare will only pay for a nursing home for up to 100 days, subject to a substantial co-payment after day 20. 

Myth #2: If I Go on Medicaid the State Will Take My House and All of My Assets

When you enter a nursing home all you owe is the monthly fee for services. If you are unable to pay that fee either privately or through insurance, you may qualify for Medicaid to pay it for you. However, federal law requires the state to try to recover the cost of the Medicaid services you received from your estate upon your death. The amount that the state can recover is limited to “the lesser of” the amount the state paid for your care on Medicaid or the value of your estate at the time of your death.

Myth #3: I Have to Spend or Give Away Everything to Get on Medicaid

The Medicaid program allows you to continue to own certain “exempt” assets and other assets that are “unavailable” to you and still qualify for Medicaid. The primary exempt asset is your home. There are some differences between the states in the exempt assets and what will be treated as unavailable, so you should seek the advice of an elder law attorney in your state.

Myth #4: A Living Trust Protects My Assets if I Need Medicaid

The assets held in your Living Trust (Link to What is a Living Trust and Why You Might Need One Post 9, Series 2) will be deemed available and countable in determining your eligibility for Medicaid to pay for long-term care in a skilled nursing facility.

Myth#5: If I Go into a Nursing Home on Private Pay, the Nursing Home Can Evict Me When I Qualify for Medicaid

Federal law prohibits a nursing home from evicting patients other than for a very select list of reasons. Qualifying for Medicaid is not one of them. So, as long as the nursing home is a qualified Medicaid facility, it cannot discriminate against you on the basis of your source of payment for care.

These are just a few of the misconceptions and confusions surrounding Medicare and Medicaid. You should seek the advice of an elder law attorney regarding your long-term care planning.

Additional Information on North Carolina Medicaid Assistance for Nursing Home Care:

Download a free copy of Jackie Bedard’s book, The Ultimate Guide to Paying for Nursing Home Care in North Carolina, to learn the nursing home and Medicaid secrets you need to know to avoid going broke in a nursing home and leaving your family penniless.