It’s difficult to know the real Medicaid facts: What does Medicaid cover? How is it different from Medicare? How do you qualify for Medicaid?
While it would take more than a single blog post to cover all the Medicaid facts you need to know, let’s focus on a few key items that will help you begin to understand the process.
Medicaid Facts #1: Medicaid and Medicare are completely different.
Medicare and Medicaid are both government programs, and they both help cover healthcare costs, but that is where the similarities end.
Medicare is a federal government program that provides health insurance. Medicaid covers long-term living costs (assisted living and skilled nursing, mainly), but Medicare only covers a limited amount of hospital and rehabilitation days.
Medicaid eligibility is based on income, but everyone 65 and older is eligible for Medicare. These are just a few distinctions, but it’s important to know that the two words are not interchangeable.
Medicaid Facts #2: There are two types of Medicaid: Institutional and Community
Institutional Medicaid (also known as Chronic Medicaid) covers nursing home care. Community Medicaid covers care at home.
Medicaid Facts #3: Income qualifications for Medicaid vary, depending on state of residence.
Because Medicaid is a state-funded program, the income requirements will vary depending on where you live. To simplify things, generally, if you make less than the poverty level and are elderly, you will qualify for Medicaid. In 2021, the poverty level for a family of two in all states except Hawaii and Alaska was $17,420, and for a family of one was $12,880.
Medicaid Facts #4: The “look-back” period for your income and possessions matters.
Medicaid will review documents to discover your assets: bank statements, tax returns, property deeds, and more. They want to see that people didn’t simply gift their house to their children, or give away money to family, in order to qualify for the income requirements for Medicaid.