With all the definitions, requirements, and restrictions of Medicare, Medicaid and VA Benefits, an reasonable person would request and NEED a road map to navigate the system. The advantage I have as an Elder Law attorney is that I travel these roads day in and day out. And every day that I am assisting a client and helping him or her make the best decisions for their future, I find myself defining the essentials and answering these questions. I hope this Medicare Medicaid comparison and glimpse into how they work with VA benefits is useful.
Federal program available to all U.S. citizens 65 and older and people with certain disabilities. Available regardless of income and has 4 parts:
Part A– Hospitalization coverage
Part B– Medical insurance
Part C– Privately purchased coverage that supplies services offered by A & B and some additional services
Part D– Prescription drug coverage
Part A and B are paid by payroll taxes and deductions from Social Security income. Parts C and D are paid out of pocket.
Joint Federal and State program but has strict eligibility requirements. Rules vary by state but are designed to help the poor. There are income and asset limits. Medicaid is the nation’s single largest source of long term care funding.
What is Dual Eligible?
Someone who receives Medicare and then becomes Medicaid eligible, is considered “dual eligible” meaning they are covered by both Medicare and Medicaid. Medicare will continue to cover physician visits and hospital care and Medicaid will cover the cost of care not covered by Medicare such as long term care costs. Medicaid will also cover the cost of your Medicare insurance, co-pays, and deductibles and prescription drug costs.
How do Medicare and Medicaid work together to pay for long term care?
How do VA and Medicaid work together?
The VA (for those who are eligible) will pay for Aid and Attendance to help cover the cost of care in the home or in assisted living. VA will also cover long term care cost in a VA home or VA approved facility if the veteran is eligible.
The rules for VA eligibility and Medicaid eligibility are different and if you spend-down to qualify under VA rules you may, in some instances, become ineligible for Medicaid.
This is provided for educational purposes only and is in no way to be considered legal advice. Please consult an elder law attorney to advice specific to your situation.