Medicare vs Medicaid | Cary NC | Carolina Family Estate Planning


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At Carolina Family Estate Planning, we understand that creating an estate plan is not the easiest topic to discuss. Perhaps the discussion started after a major life change, like a birth in the family or a loved one’s move to a nursing home. Regardless of the reason, rest assured that our firm is dedicated to providing members of the communities of North Carolina with extensive resources to help you make the best decision for you and your family.

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Carolina Family Estate Planning
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What is the difference between Medicare and Medicaid? Will Medicare pat for nursing home care?
Generally, no. Medicare is not going to pay for nursing care but let’s back up a little bit and explains why. A lot of people get these programs confused. Medicare is the program that you qualify for at age 65 and think of Medicare as your healthcare insurance. It usually helps with things like a trip to the hospital or a doctor’s office. Think of it as short term care. And then Medicaid is a need base program, Medicaid is like financial aid. There’s a lot of different Medicaid programs but for our purposes, usually the one that we’re concerned about is Medicaid for long-term care expenses for seniors and that’s when Medicaid will help pay for nursing home care. A lot of people get those two term twisted around because they do sound so similar. So often you may hear somebody say when grandma was in the nursing home Medicare paid the bill or when my parents were in the nursing home they got some help from Medicare and most of the time it was actually Medicaid that was helping them and they might just be confusing the two programs. What can create some additional confusion is Medicare, which is again the one like health insurance, Medicare will help pay for rehabilitation so what might happen is when someone is admitted to the hospital for at least 3 days overnight stay and then they are discharged from the hospital directly to the nursing home for rehabilitation, Medicare can pay for that rehabilitation for a period of time that the rehabilitation may take place at a nursing home. The amount of coverage there can be anywhere up to a hundred days. Medicare will pay the first 20 days and then days 21 up to a hundred there’s co-pay but it’s really however long care that is needed. 100 days is not guaranteed if the person only needs 30 days then that’s what they’ll receive but that’s still more of a short term situation, we’re talking about long term care then Medicaid is typically the program we’re going to be talking about. And it can be really important to understand that distinction because our current health care system can create some really different outcomes depending on what programs we’re talking about. A way I like to explain to people is imagine you might have 2 neighbors, they live across one another, they have similar careers, and they try to do the right thing so they saved up for retirement now they’re retired. Neighbour number 1 has a massive heart attack, goes to the hospital, receives treatment, he’s in the hospital for a few days, they patch him up, he returns home. That’s going to be your classic Medicare type of situation. You might be responsible for some co-payments out of pockets but often you’re supplemental insurance if you have a policy that will help with that.

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