Long-term Care Medicaid vs Insurance: What's the Difference?

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Beneficent: LTC Funding Education & Options

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Apr 20, 2023

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Understanding Long-Term Care Medicaid and Insurance

The #1 cause for people filing for bankruptcy due to medical bills.

“A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues.” Therefore, the cost of long-term care is often a major concern for families. When it comes to managing the costs associated with long-term care, there are 2 primary options available to individuals and families.

  1. Long-term Care Medicaid
  2. Long-term Care Insurance

Before deciding which option is the best fit, it’s important to understand the differences between these two types of coverage. Read on to learn more about understanding Long-term Care Medicaid and Insurance.


Long-term Care Medicaid

Long-term care Medicaid is a government program that provides medical and related services for people who meet certain income and resource requirements. This program is jointly funded by state and federal governments, so the details can vary from state to state. In general, eligibility requirements include being over 65 years old, blind or disabled and needing help with more than 2 of the activities of daily living. (Activities of daily living examples – getting dressed, bathing, cooking, and more.) In some cases, individuals may be eligible for Long-term Care Medicaid even if their income and resources exceed the eligibility limits.

 

Long-term Care Insurance

In contrast to Long-term Care Medicaid, Long-term care insurance is an individual policy that you purchase from an insurance company. This type of coverage pays for custodial services such as assistance with activities of daily living like bathing and dressing as well as inpatient nursing home stays up to a predetermined amount per day. It can also cover other professional services like adult daycare programs or home health aides. Depending on your policy, you may also be eligible for additional benefits such as mental health treatment or respite services for family members who are providing care at home.


Pros and Cons

Many people find that they cannot afford the high premiums associated with Long-term Care Insurance, and Medicaid is a great option when it comes to paying for long-term costs.  Preexisting conditions may also hinder an applicant’s ability to attain a Long-term Care Policy. With a lot of misinformation, many people also find it hard to determine if they are even eligible for Medicaid.                                                                                                                                     

Deciding which type of coverage—Long-term Medicaid vs Insurance—is right for your situation can be difficult because of their complexities. Both options have their pros and cons but understanding them both can help guide you toward making an informed choice about how best to manage the costs associated with long-term care. Need to determine if you are eligible for Medicaid? Meet with Stacy Osborne, a Medicaid Certified Planner. In 1 hour, you will walk away with a Long-term Care plan in place at no charge.


  Stacy Osborne, MBA, CMP 
  Beneficent CEO
  719.645.8350




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Having the Difficult Conversations About Change

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