Medicare and Medicaid Explained
Many people are confused about what Medicare and Medicaid cover. Here’s a breakdown to clarify:
Medicare Overview
- Purpose: Covers temporary care, typically for post-surgery recovery or illness.
- Assisted Living: Medicare does not pay for assisted living or long-term care.
- Coverage Details:
- First 20 Days: Covers 100% of costs for a semi-private room in a skilled nursing facility (SNF) (including room, meals, nursing services, and supplies).
- Days 21–100: You pay a co-payment of $200 per day (2023).
- After 100 Days: Coverage stops entirely.
- Improvement Requirement: Medicare stops paying if no improvement in health is shown during the 100-day period.
Medicaid Overview
- Purpose: Designed for low-income seniors; regulated at the state level (in Florida, by the Agency for Health Care Administration).
- Skilled Nursing: Medicaid covers 100% of the costs for skilled nursing care in Medicaid-certified facilities (semi-private rooms) if eligibility criteria are met.
- Assisted Living: Medicaid does not typically cover assisted living.
Medicaid Waiver Program (Florida)
- Purpose: Assists with costs in assisted living.
- Details:
- Provides approximately $1,800/month for care-related charges (not room and board).
- Waiting Period: Approximately two years.
- Eligibility: You must already be paying privately and residing in an assisted living facility.
- Facility Participation: Not all assisted living facilities accept the Medicaid Waiver.
Caution on Assistance Services
- Some companies promise Medicaid eligibility assistance for a flat fee.
- Warning: Be cautious of unrealistic promises or guarantees.
For more information, visit: 🌐 Medicaid (myflorida.com)