Generally, Medicare is a federal program which bases eligibility solely on age and/or disability. In terms of nursing home care, Medicare is limited to covering care in skilled nursing facilities, after a patient has been in the hospital for at least three days. Coverage is restricted to a finite period of time, up to 100 days, but in practice usually only about 10-20 days for rehabilitation.
Coverage through Medicaid, a joint federal and state program administered by the states, is quite a bit broader. Eligibility is based on age, disability, and/or income and financial resources. Medicaid will potentially cover long-term “custodial” nursing home care for eligible individuals. If Medicaid is invoked based on financial eligibility, a “look-back period” of 3-5 years will be used to see if any assets have been transferred for less than market value in an attempt to become eligible. If so, a penalty in the form of a period of denied eligibility may be enforced. The Deficit Reduction Act of 2005, passed by Senate in December of 2005, has tightened the regulations on this.
If you would like more information or would like to speak to an experienced lawyer please contact Tipton Jones.
Paul W. Tipton
(214) 890-09941
ptipton@tiptonjoneslaw.com
