Why Medicaid and Medicare Matter in End-of-Life Planning
When we think about planning for the end of life, we often focus on wills, advance directives, and funeral arrangements. But one of the most important and overlooked pieces of the puzzle is how we'll pay for care when we need it most.
Medicaid and Medicare matter for end-of-life planning because it is often the only way many people can afford dignified, appropriate care in their final months or years without placing an enormous financial burden on their loved ones. What are Medicaid and Medicare? Here's why these programs are so important to include in your end-of-life planning.
What Medicare Covers — and Doesn't
Medicare is a federal health insurance program primarily for people 65 and older and for some younger individuals with disabilities.
At the end of life, Medicare can help cover:
Hospital stays and some medical care.
Certain home healthcare services.
Hospice care for those with a terminal diagnosis.
However, it's important to understand what Medicare does not cover.
Long-term nursing home stays.
Ongoing custodial care.
Treatment or medications intended to cure the illness that placed a patient under hospice care.
Care in a facility may not be covered unless the hospice team determines that the patient requires short-term inpatient or respite care.
Providers that are not set up by the patient's hospice team.
What is and is not covered may vary by patient. It is important to check with the facility to be sure you understand what is covered and the proper procedures to follow to continue to receive benefits.
How Medicaid Can Fill the Gaps
This is where Medicaid comes in. Medicaid is a joint federal and state program that helps people with low income, and limited resources pay for health care.
At the end of life, Medicaid can:
Cover long-term nursing home care, which Medicare does not.
Provide in-home personal care services in some states.
Relieve the financial burden on family members by covering costs you might otherwise have to pay out of pocket.
Medicaid is often the only way many people can afford the level of care they need, especially if they require extensive support in a nursing home or at home.
Why You Need to Plan Ahead
Medicare is available to most people automatically at age 65, but Medicaid eligibility is based on income and assets. Some states also have "look-back" periods that penalize you if you transferred assets shortly before applying.
This makes early planning important. Speaking with a financial planner or lawyer can help you:
Understand your state's Medicaid rules.
Protect certain assets while qualifying for benefits.
Plan financially for potential long-term care needs.
Understand Filial Responsibility Laws (laws that could obligate adult children to support their parents financially) if present in your state.
Protecting Your Loved Ones
Both Medicare and Medicaid can help ease the financial and emotional burden on your family. By ensuring you have access to care when you need it, you help prevent your loved ones from having to take on caregiving duties or facing overwhelming medical bills.
End-of-life planning is about more than just medical decisions and memorial services — it's about making sure your needs are met, your family is protected, and you can face this stage of life with peace of mind.
Medicare and Medicaid are vital tools in this process, but they work differently and have limitations. Understanding them now and planning ahead can help ensure you get the care you deserve without unnecessary hardship for you or your loved ones.
Why Medicare and Medicaid Matters
You are going to need it. For yourself or a loved one, both Medicare and Medicaid provide care and assistance for millions who could not otherwise afford it. These programs -
Make healthcare accessible to millions of Americans who might otherwise go without
Provide dignity and support in old age or during serious illness.
Protect families from the crushing costs of long-term or end-of-life care.
Enable people to focus on comfort and quality of life rather than worrying about bills.
Medicare and Medicaid are vital safety nets that make compassionate, appropriate care possible — for everyone, regardless of wealth or circumstance.
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Resources:
The US Department of Health & Human Services - Medicare & Medicaid
Medicaid Programs by Another Name
As I was speaking to a friend about this blog post, she brought up TennCare (we are in Tennessee). It is worth mentioning that the following programs are some additional Medicaid-funded programs. Some states rename Medicaid programs to distinguish their specific rules and benefits from the basic federal Medicaid framework and make them more marketable to the public.
State Medicaid Programs
TennCare – Tennessee
SoonerCare – Oklahoma
Medi-Cal – California
MassHealth – Massachusetts
Husky Health – Connecticut
BadgerCare Plus – Wisconsin
Apple Health – Washington State
NJ FamilyCare – New Jersey
KanCare – Kansas
RIte Care – Rhode Island
Healthy Indiana Plan (HIP) – Indiana
PeachCare for Kids – Georgia (children's program under Medicaid/CHIP)
Health First Colorado – Colorado
CHIP Programs
Many states also brand their Children's Health Insurance Program (CHIP), which is also federally and state-funded.
Florida KidCare
All Kids (Illinois)
Dr. Dynasaur (Vermont)
CHIP often works alongside Medicaid to cover children in families who earn too much for Medicaid but not enough for private insurance.
Home- and Community-Based Waivers (HCBS)
Some states offer special waiver programs funded by Medicaid that let people get care at home or in the community instead of nursing homes.
PACE (Programs of All-Inclusive Care for the Elderly) This is a national program, but each state runs it.
New Choices Waiver (Utah)
Independent Choices (Arkansas)
