Medicare versus Medicaid in MA. Is it true that Medicaid has extremely restrictive benefits and Medicare is much better? - AgingCare.com

Medicare versus Medicaid in MA. Is it true that Medicaid has extremely restrictive benefits and Medicare is much better?

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My parents migrated about 5 years ago and live in MA. They don't have any earnings and we support them for their living expenses. So far we have been buying health insurance from open market. Now that they have completed 5 years, they will be eligible to get Medicare/Medicaid.

My question is would they be eligible for Medicaid? My brother is totally against applying for Medicaid as he believes they won't get the care they deserve from Medicaid and he wants me to buy Medicare.

Is it true that Medicaid has extremely restrictive benefits and Medicare is much better? I will really appreciate any insight, thought and comments. Also, if you could please point me to some other resources for me to convince my brother.

Regards,

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It isn't really isn't either/or. I don't know how immigrants qualify, so you'll need to factor that special circumstance in.

Generally, everyone who has worked and has paid into social security is eligible for Medicare. It is not based on need or on income, etc. If you are entitled to it, you get it. (In fact you can't turn it down). Many people wish to supplement that insurance with commercially available policies, that may cover the deductibles and generally provide more comprehensive coverage. Not everyone does this, or needs it.

Medicaid is an entirely different program. It is for persons of low-income who have high medical needs. For example, if you have a catastrophic illness like dementia or cancer it might not take long before your savings are used up, How are you going to pay for a nursing home, or for in-home care and equipment like a hospital bed or a lift, etc. and maybe a visiting nurse or a health care aide? Medicaid is the program set up to help in these situations, using tax-payer money.

Would your parents be qualified for Medicaid? It sounds like they would financially. But do either of them have a severe chronic illness such that they would need a nursing home or similar care at home? Medicaid is not for routine medical care. Providers of services and goods are not required to accept Medicaid. If they choose to, they receive a smaller compensation than they can get on the open market. I can understand why your brother fears the Medicaid services would be inferior. There is a smaller pool of vendors to choose from -- some have removed themselves from the pool. But often the very excellent providers including teaching hospitals and clinics and well-known public institutions do accept Medicaid. Also, among places that have both private-pay and Medicaid-paid patients, the billing office knows the difference, but I have heard from many sources that out on the floor it makes no difference. The care provided is the same, and private-pay residents of a nursing home, for example, do not get preferrential treatment. If there are specific items that you'd like a better quality than Medicaid cover, you can simply buy that item yourself. For example, if Medicaid only provides a manually cranked hospital bed and you want a fully electric one, don't put the order through Medicaid, but instead buy it yourself. But note that Medicare does not cover long term care at all. Your choice for long-term care is not between Medicare or Medicaid. It is between paying yourself, having a private long-term-care insurance policy (which will be very expensive at your parents' ages), or tax-supported Medicaid.

If your parents can now sign up for Medicare, awesome! Do it, and consider carefully whether you also want a supplemental policy for them.

If the time comes when one of them needs the level of care that a nursing-home provides, I would not histiate to sign up for Medicaid for fear of inferior service.

Good luck to you and your family!
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