Know the Difference between Medicare, Medicaid and MassHealth

With so many government programs out there it is easy to confuse which one can help with what. It doesn’t help that Medicare, Medicaid and MassHealth all sound similar and

POSTED ON: March 21, 2012

With so many government programs out there it is easy to confuse which one can help with what. It doesn’t help that Medicare, Medicaid and MassHealth all sound similar and are often talked about together. However, knowing the difference between these programs is an important distinction for seniors planning their estates and protecting their health.

Medicare is the federal health insurance provided to seniors over age 65. Medicaid, on the other hand, is a joint federal/state assistance program designed to pay for health care for individuals that meet certain income and asset guidelines. MassHealth, meanwhile, is just the name we use for Medicaid in Massachusetts—the programs are the same for Massachusetts residents.

Just because you are currently receiving Medicare benefits, does not mean you will automatically qualify for Medicaid. To qualify for Medicaid your total resources and income must fall below some fairly stringent eligibility limits. There are also restrictions on how you can transfer assets.

The distinction between Medicare and Medicaid becomes very important when you or a loved one are in need of long-term care in a nursing facility. If you suffer a sudden illness, Medicare will pay for your care in a hospital or nursing facility for up to about 4 months at most. If your need for care is longer or indefinite, then you will be expected to pay out of pocket for your care, which can cost about $10,000 per month in Massachusetts currently. However, if you qualify for Medicaid in Massachusetts these costs can be paid.

To help families plan for the potential of an extended stay in a long-term care facility, the Heritage Law Center often designs trusts to ensure that you will qualify for Medicaid so that you want won’t be forced to spend all of your assets down on a nursing home once your Medicare benefits run out. This can be essential in avoiding nursing home poverty and providing a legacy for your loved ones.

If you are interested in learning more about Medicaid Trusts in Massachusetts and how the Heritage Law Center can help your family avoid a nursing home spend-down, call us today.