Finding professional and caring home care services for an elderly family member can be challenging. Families express concerns over the prevention of elder abuse and how they can protect a loved one’s legal rights. Seeking advice from an experienced elder law attorney can help you make the right decisions when it comes to your elderly loved ones.
Although Medicaid and Medicare provide essential services for our loved ones and thousands of Americans, many people either do not know the specifics of each program or simply do not know the difference. Well not anymore! Provided below are the basics everyone should know when dealing with these two aid programs and a basic layout of their differing eligibility requirements, coverage, and funding.
Medicare is a federally funded and administered program that provides health insurance for individuals older the age of 65, individuals with disabilities, or individuals with End-Stage Renal Disease (ESRD). Its coverage includes: inpatient services from a hospital or nursing facility, outpatient services, doctor visits, and preventive care, prescription drug costs, or a combination of these services. Most seniors are automatically enrolled when they turn 65, yet those that are disabled are required to contact their local Medicaid office if interested in being enrolled, however cost is not distinguished by qualifying factors but rather is the cost depends on the “level of coverage” assessed.
Medicaid is a federal and state program that is administrated by the state government with the purpose of providing coverage for low-income families. Its coverage includes: hospital and nursing care, certified pediatric and nurse practitioner services, access to federally qualified centers, as well as access to rural health clinic or birth centers licensed by the family’s state. All of those who wish to receive Medicaid benefits must apply within their state office in order to become eligible and costs depend on the income of each family.
Can A Person Qualify for Both Medicare and Medicaid in New York?
Individuals may be dually eligible for both programs. In many of these cases, Medicaid will cover Medicare premiums or co payments for the services covered under Medicare. This allows for effective and comprehensive health coverage.
Contact an Attorney
If you believe you qualify for Medicare or Medicaid and wish to receive benefits, or if you have been previously denied coverage, contact an experienced New York Elder Law Attorney. A skilled attorney can analyze your situation, discuss your options with you, and help ensure your legal rights are protected.
On April 8th and 15th, 2011, the State Commissioner of Health sent all CHHA administrators two directives reminding them that state law does not allow CHHAs to reduce home health aide services that were previously authorized, without doctor’s orders and notice and hearing rights. Similarly, if a CHHA client is hospitalized, or in temporary short-term rehabilitation, these changes do not allow the CHHA to abandon them — the CHHA must reinstate the same home health services after the hospital or rehab stay is over, if the client continues to need the services as prescribed by his/her treating physician.