On the Beat - Stevens

Troy: welcome to on the beat everyone.

I'm troy thompson.

I'm in the studio today with sarah cline stevens who's attorney at law.

And today, we're talking all about medicaid versus medicare for the elderly.

Welcome to the show, my friend.

Sarah stevens: thank you.

Troy: nice to see you again.

Now, explain to everyone at home, because i know i get confused, medicaid versus medicare?

Sarah stevens: well, medicare is something that is offered to almost everyone age 65 or older.

It has no income or asset limits.

Whereas medicaid is an entitlement program, it's needs based, it's offered to the low income and you must meet certain income and asset limitations in order to qualify for that insurance.

Troy: well, how do we find out what those limitations and qualifications are?

Sarah stevens: well, a lot of times that will be contingent on the circumstances of what you need.

Troy: okay.

Sarah stevens: in my practice, particularly this concern comes up regarding skilled nursing care or nursing home care.

My clients assume that medicare will cover their long- term care planning stay, but in reality, medicare is structured to only cover short term nursing home stays.

It's never going to cover more than 100 days and there are requirements to make medicare kick in.

Like you normally have to be hospitalized for a certain number of days and be discharged to a skilled care facility with specific rehabilitation instructions.

Troy: well, look, as i said at the beginning of the interview, there's a lot of confusion.

In your practice you deal with this.

Where does the confusion come from?

Why are we getting so much different information on every term?

Sarah stevens: well, i think part of that's because they sound alike, medicare and medicaid.

And until you're in a skilled nursing facility situation, maybe you've never even thought about medicaid before, but the cost of that care can be so expensive.

If you stay past that hundred days or you do not meet the rehabilitation criteria to continue improving, then you're going to switch to private pay, which can be between $212 to $225 a day locally, which is, it can add up to $8,000 a month, which can be a huge financial strain on your retirement security.

Troy: well, that's just an understatement?

Sarah, and we said earlier on in the commercial break that one of the number one reasons for bankruptcy in america is health?

Sarah stevens: absolutely.

Troy: and medical bills.

Been there, done that.

One of our viewers who knew you were coming in wrote a question to us.

What happens if i'm discharged from way with rehab instructions but cannot complete the rehab?

Sarah stevens: right.

So what happens is medicare will stop paying.

If you cannot continue to meet those benchmarks for improvement, you will be switched to a private pay rate if you do not automatically qualif medicaid.

And medicaid does not happen automatically.

You absolutely must apply and you have to make the income and asset limits, which the asset limits are very different for married couples versus a single individual.

Troy: actually, you did mentioned.

Yeah.

Sarah stevens: so for a single person, you can only have $4,000 of countable resources.

And now accountable, that's a term of art.

Not everything counts, but a lot of things do.

If you're married, the financial picture is a little bit better.

The person who needs skilled care, again,