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Can someone tell me what's the difference in Medicare to Medicaid please.

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Essentially medicare is the insurance provided to elders by the government; it is paid for through Social Security, and a portion of Social Security is withdrawn monthly for medicare insurance. Then when there is medical need a portion of the bills are paid by medicare. There are several parts to it and it is complicated, and most people have medigap insurance as well, from United Health Care/AARP program, through a hospital such as Kaiser, or in any number of ways. That is all very complicated in choosing and more complicated even than that is Medicaid which takes over when there are no funds. An elder must be flat out BROKE with some small amount they can keep and with some monthly allowance, and then Medicaid comes in to provide care (albeit not as good or as expensive care as that the elder pays for him or herself. I think what Mom means is that THEY OWN YOU in the sense they have a right to investigate every single asset you have to be certain that the government is not paying for someone with a pile of saving they could use themselves. Moreover, after death Medicaid can attempt to"recover" money spent on the elder when protected life assets such as a home is sold.
There are books out there such as Medicare for Dummies, but I will tell you it is hideously complicated and kind of learn as you go. She is right. They are all in your business, including looking back five years to every penny they can see that you spent or gave away.
So this BIG question is way to complicated for little me. But this gives you some TEENSIE idea as to what it is all about. Ha, stick with Mom. Looks like she may know whereof she speaks in a sense.
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worriedinCali Aug 2019
Medicaid actually does NOT have a right to investigate every asset you own. You have to disclose CERTAIN assets but there are some they cannot touch.
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Medicare is the health insurance that all working Americans pay for with every paycheck. That you become eligible for at 65.

Medicaid is public assistance insurance for the poor and needy.
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Medicaid is for the truly needy. There is community Medicaid for medical and drug expenses. Long term care Medicaid for nursing home coverage. Both are need based and determined by income and asset qualifications.
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I'm coming at this from a very different cultural background, because in European countries I think there is probably less stigma attached to receiving state benefits than there used to be here or currently seems to be in the States. But one of the things I've realised after years on the forum is that whatever the approach, the aim of almost all governments and societies worldwide is pretty much the same: to ensure that no citizen of any society that wants to call itself civilised is left sick or starving or homeless.

(I never said any of them necessarily achieves that aim.)

If or when she needs Medicaid, the state doesn't own your mother. It owes her, in her old age and infirmity. She's done her bit, hasn't she? She's paid her taxes and been a good citizen? So now, if she needs care or health care and doesn't have the means to pay for it, the state is responsible for ensuring that her needs are met. It's the state's duty to do that, enshrined in law.

My personal problem with many of these "safety net" services, and others such as education which have historically been taken over from the church and other charitable institutions by the state, is that states tend to run them badly. But that's another question.
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NeedHelpWithMom Aug 2019
CM,

It’s true a safety net is needed at times. Why some people view that as shameful boggles my mind. As you say, if we are good citizens so be it. Actually, all human beings deserve dignity. Thanks for sharing valid points.
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Medicare A is hospital care, Medicare B is physician/medical benefits and part D is drug coverage. They’re are also private pay supplemental policies to cover what Medicare doesn’t pay

You can have Medicare and also apply for Medicaid.
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NeedHelpWithMom Aug 2019
Thanks, Becky.

Yes, mom has Humana gold plus as a supplement.
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A person must work for 10 years and pay into the Medicare system to be eligible for Medicare (just wanted to add that - pardon me isthisreallyreal. )
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NeedHelpWithMom Aug 2019
Shane,

I don’t quite understand Medicaid either. Work? A job? What about a homemaker like my mom was all her life. I’m confused.
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NHWM, a person can qualify for Medicare on their spouse's work history, but they may then need to pay for Part A.
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NeedHelpWithMom Aug 2019
Barb,

I guess I need more education. I do my best to understand all of this stuff but I get confused at times. I have no idea what those separate parts of Medicare are. The other thing I don’t get is when I see people post about having Medicare and Medicaid. So do you apply for Medicaid and you still keep Medicare? Forgive me ignorance!

Can you explain a bit more, please. Another thing, this pay down stuff. I guess I screwed up because mom is 93, almost 94 so if she does end up needing LTC in a NH will I have to pay back money? Sorry to ask so much. It’s just not totally clear to me. I’ve tried to read up on it from time to time but honestly, I get somewhat confused. Here in Louisiana it’s five years. So that would make mom close to 100 to qualify for Medicaid.

What about hospice? That’s covered by both, right? Medicare and Medicaid.

Sorry for being such a dummy! Hahaha. You’re a gem for answering our questions. You have way more experience in these things. I’m trying to learn as I go along.
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Medicaid basically takes over when you have no money left to pay for health care. If your Mom needs to go into a Nursing Home for an extended period, she likely will need Medicaid to pay for it. Medicare does not cover Long term care in a NH.
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