One potential consideration when applying for Medicaid nursing home coverage is whether or not to continue paying for additional health insurance through Medicare.

Qualifying for Medicaid nursing home coverage would also make individuals eligible for health insurance through Medicaid. Medicaid, known as MO HealthNet in Missouri, can vary significantly from state to state. Additionally, Medicaid health insurance also exempts individuals in nursing homes from additional out-of-pocket expenses for health care.

However, there are reasons why individuals should strongly consider continuing enrollment in health insurance through Medicare.

First, more health care providers cover patients on Medicare compared to Medicaid. The reason for this disparity is that Medicaid reimbursement rates to health care providers are lower than reimbursement rates under Medicare. Due to the reimbursement rate disparity, some health care providers may deliver more comprehensive care to patients on Medicare.

Second, health care premiums are exempt from the calculation of how much individuals have to pay out-of-pocket for nursing home care. If individuals choose to drop their Medicare insurance plan, however, this money is not saved to be kept by the individual, but would have to be paid for the individual’s nursing home coverage.

For these reasons, if a person already has health insurance through Medicare they should almost certainly continue to pay their Medicare premiums if they apply for Medicaid nursing home coverage. Continuing enrollment in Medicare will allow individuals to continue to receive the level of care they are used to from their current doctors and health care providers.

Before even considering applying for Medicaid nursing home coverage, individuals should meet with a local, experienced elder law attorney to discuss all the available planning options to protect their assets and avoid any unnecessary expenses.

To discuss your health insurance, and other planning options, before a potential application for Medicaid nursing home coverage, please call Martha C. Brown & Associates at (314) 962-0186.