Medicaid Long-Term Care Eligibility and Your Home

The Medicaid application in North Carolina can be a tricky minefield for people experiencing it for the first time. Disability, income, assets - all with different standards and different ramifications on your (or your loved one's) eligibility. And while not all assets are treated equally, how you respond to a certain eight word question can have a very significant impact on Medicaid eligibility and future medical treatment.

What is the Difference Between Medicaid and Medicare?

Cary, NC Elder Law Attorney

Cary, NC Elder Law Attorney

Both are federal programs, both are administered at the federal level by the Center for Medicare & Medicaid Services (CMS), and they both sound pretty similar. But what's the difference between Medicaid and Medicare?

What is Medicaid?

Medicaid is an assistance program. It is meant to provide health coverage for people below a certain asset and income threshold - what Medicaid would consider impoverished. It serves people at every age, but is means-tested. Medicaid is also a federal-state program, meaning that the federal government provides funding and guidance, but the program itself is administered at the state level. Rules for eligibility and administration can vary somewhat state-to-state. At its core, Medicaid is meant to provide a health care safety net for those who would otherwise go uninsured because of a lack of means. 

Medicaid can be used by the young and elderly equally. Disabled children may be eligible for Medicaid based on a marked or severe impairment, while disabled individuals 65 and older may be eligible for Medicaid Long-Term Care benefits if their disability impacts at least two activities of daily living and they are also poor, as defined by the Medicaid regulations. 

What is Medicare?

Medicare is an insurance program. Often considered an "entitlement" because it is paid into during your lifetime, Medicare makes payments on behalf of a participant from trust funds which the participant has paid into through their payroll deductions throughout their professional career. Medicare primarily serves those 65 and older, regardless of their income, but it can also serve disabled individuals under age 65. Participants often pay a co-payment for health services, and will sometimes use a supplemental health insurance policy to fill the gaps in Medicare. Medicare is a federal program, so its administration is pretty much the same across the US. It is run directly by CMS, rather than at the state level.