Medicaid Is Just Fine, Isn’t It?

If I had a nickel for every time I heard people say that Medicaid gives you the same care as paying for care does………

True, there is no sign above the door in your facility stating if you are paying the full bill for care or if Medicaid is paying the bulk of it.  However, getting in to the facility you would like to be in can be very difficult.

Medicaid does not pay the same amount to a LTC facility as you or I would if we needed to be there.  If one spends down to Medicaid impoverishment and applies for Medicaid benefits, the facility cannot ask us to leave due to the change in payment source.

They can, however, refuse to admit someone for financial reasons.  It is usually done very tactfully, the admissions person you meet with might inquire about the cares your loved one needs.  After listing those cares you might be advised that they do not currently have the staffing, equipment, etc. to provide the needed care.  Unfortunately you may need to look elsewhere.

The problem is, it is not possible to lose money on every customer, and make it up with volume.  The problem simply continues to get worse until they close their doors.  That has happened to a number of facilities, and the others have learned from this.

The Medicaid reimbursement can be from one to several thousand dollars a month less than the cost of care.  The assisted living type facilities suffer the most as the loss tends to be a larger percentage of the rates they need to charge to remain in business.  If someone has done Medicaid planning, their family now holds their assets and they are qualified for Medicaid, will they have easy entrance into the most desirable facility?  The one most people want in to, the one that might even have a waiting list?

Now consider LTC insurance as an alternative to this.  If purchased in the 40’s, 50’s, or even 60’s if still healthy enough, the premium can be easily financed with just the interest on a small portion of life savings.  Most people have some income and interest that can be contributed to the cost of care – once care is needed.  Less income may be needed for travel, boating, camping, and other fun pursuits that are no longer manageable.  Only the difference needs to come from LTC insurance meaning less insurance may be needed than most people think.

When you pay for the care you need, you have your choice of care providers.  If you are unhappy, you can easily move to a more desirable facility or provider.  You are in control and your life savings can be left to family, charity, or anyone you desire because it is not being used up.  That is how I will pay for my care, if needed.  If care is not needed, I will be in the same position I am with my auto insurance, glad that I have not had an accident (knock on wood).  For more information visit

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  1. karenlorenzo07 on January 31, 2014 at 12:15 am

    People usually thinks that the government will take care of them when they grow old, especially when they need long term care, But just like yoiu, I will not grow old without long term care (LTC) insurance, I will not rely on the government. At least I can be sure and will have a choice on how, where and how I want to be taken cared of…

  2. imaniwilliams311 on January 31, 2014 at 8:30 am

    Enjoyed reading this post. The insights you shared about Medicaid made me depressed and worried, but I know they’re happening this very moment–facilities closing and Medicaid patients not getting the proper long-term care they need. I think for some, they really don’t have a choice. But for those who have the disposable income, I say try to invest even a small amount into a LTC insurance policy. In the end, it will give you more options when/if you do need care in the future. Very useful write up. Thanks!