Frequently Asked Questions

About Medicare and Medicaid

Q. What is the difference between Medicare and Medicaid?

A. In general, Medicare is the government benefit program that covers medical expenses such as hospital bills and doctor’s fees for individuals who are at least 65 years old, or sooner, if the individual is disabled, regardless of how much money that individual owns. Medicaid is the government benefit program that can cover nursing home and assisted living care costs, but only if the individual meets the asset and income requirements of the Medicaid program.

Q. Does Medicare cover a stay in a skilled nursing facility?

A. Yes, but Medicare coverage for nursing home care will only last for a few months, at the most. After those initial months, the nursing home care must be paid privately, at an average monthly cost in NJ of $8,000.75, or through the Medicaid program if the eligibility requirements are met.

Q. Did the Medicaid laws change in the past few years?

A. Yes, Congress passed the Deficit Reduction Act, effective February 8, 2006. This law made significant changes to the Medicaid laws, and these changes include extending the look back period and increasing the disqualification periods that result from gifting.

Q. What does the 5 year look back period mean?

A. The look back period is the time before one applies for Medicaid benefits and the 2006 law increased that period from 3 to 5 years. The change will generally result in longer penalty periods for those who gifted assets prior to a Medicaid application.

Disclaimer: We hope that this FAQ page provides you with some useful baseline legal information. However, please note that legal information is not the same as legal advice, and that no relationship of attorney and client is inferred or implied by furnishing the information contained on this website. Application of law must take into consideration an individual’s specific circumstances and any changes in law as they arise. Although we go to great lengths to make sure the information provided on our website is both accurate and useful to our readers, you should not rely solely upon this information in making legal decisions. Instead, we recommend that you retain counsel to review and serve your legal Estate and Medicaid planning needs and concerns.