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Plain language information and resources on Medicare, Parts A, B and Drug benefits and Medicaid use and abuse. Also, many pages on other senior and elder care needs.

Medicare And Medicaid Use And Abuse

Medicare and Medicaid are US Government programs designed to see to it that no one goes without basic health care, regardless of age or income.  This article is to help you understand and use these programs to supplement your other retirement plans.  For more information on Medicare coverage, visit Medicare Use frequently asked questions.  We'll also cover abuse of the Medicaid program to help you avoid it. To help understand, here are some top-selling books about using Medicare and Medicaid.

Medicare Program Use (Part A): Much of your senior the health care was already paid for through the Medicare tax you paid throughout your career.  You need to reach a qualifying age (currently 65), have a permanent disability, or have End Stage Renal Disease to receive benefits.  Once you qualify to use Medicare (part A) and pay a deductible, your required hospital in-patient care and much of the short-term skilled nursing care is covered.

Medicare Program Use (Part B): This part of Medicare covers most physician services, outpatient hospital services, some home health services and medical equipment.  You pay, monthly, $ 78.00 and $ 110.00 per year deductible.  Many people buy an insurance called "gap" to cover the co-payments and deductibles not covered by Medicare parts A and B.  See Gap Insurance Coverage for more info.

Medicare Drug Discount Card: If you have Medicare Parts A and B, you may be eligible for a drug discount card which can save you 15% or more on prescription drugs.  If you already have prescription drug benefits under Medicaid, you don't need the card.  If you have other prescription drug benefits, the card may not benefit you.

Medicaid Program Use: If you're over 65 and are eligible under the poverty criteria established in your State, you may qualify for Medicaid coverage of medical, skilled nursing, assisted living and other expenses.  See the Medicaid Use information page to find qualifications for your state.  Since Medicaid is for poor people, they will need to know the value of your home, cars, bank accounts, etc.  Once your assets are spent down to the qualifying level, Medicaid would cover long term assisted care and medical care.  As you can see, this is a last resort situation for when you have no other means.  If you're in this situation, your needs will be met.  There are long term care facilities that specialize in Medicaid care with no additional fees.  While they provide for your needs, they're not the luxury option.  If it's still early enough in your life, it's best to invest for a better quality of life in the end.  See our pages on Financial Management Planning Help for more ideas.

Medicaid Program Abuse:   Unfortunately, there are now lawyers who want to make rich people look poor as far as Medicaid is concerned, so they don't have to pay for their long-term assisted care.  Having seen the facilities, I can tell you it takes the utmost of greed to make someone subject themselves or their "loved" one to this level of care if they have the money to do better.  If you're without options, this care is a wonderful thing, but it ain't the Hilton.  Still, many misguided people have paid lawyers thousands to hide their assets so they can enjoy their remaining years at taxpayer's expense.  Here's why this is one of the dumbest things someone with money can do:
1.  They can afford to do better.  $ 4,000 per month will cover all living expenses for assisted living and most skilled nursing situations not covered by Medicare.  In most US locations, it would cost far less for a luxury assisted living suite.  If you have $ 1,000 per month total retirement income and $ 300,000 net assets (below average US home value) earning Money Market interest, your estate would last over 10 years before you needed Medicaid.  The average time someone stays in assisted living before they pass on is 2 years...less than 5 % stay longer than 10 years.  The more assets, the less sense it makes to dispose of the money and live off the dole. If you need assistance to live, it's likely you won't outlive your assets.  If you do, thank God your needs will be met by Medicaid.  You want to leave your assets to your children?  If they love you enough to deserve your money, they would rather you spend it to have the best quality of life in your remaining years.  This is the principle meaning of "Honor your father and mother."
2.  It robs younger people who earned the money and who have less, by forcing them, through taxes, to pay bills you could pay.
3.  Even if you find "legal" ways to do it, it's immoral.  If you're a family member being asked to take part in this, say "no", or at least get your own lawyer to make sure you aren't committing Medicaid Fraud.
4.  It gives the kids and grandkids a bad lesson about responsibility and gives them a really sad last look at you and your character.

Finally, we in the US are lucky enough to live in a country where we'll get necessary medical and assisted living care regardless of age and financial ability.  This doesn't mean we have nothing more to worry about.  This is a very frightening time of life, not knowing from one day to the next what will change, controlling less and less of your life.  Fortunately, we have someone who loves us and will help us get through.  That someone is God.  If you want help from God, click on God Help Me.

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