Change text size: A A
The Myth of Medicaid
The Myth of Medicaid as a Poverty Program
Confusion over Medicaid also arises because it provides health care for both poverty-stricken families and for older adults needing long-term care. Although Medicaid fraud generates headlines, the fraud rate has been estimated at only 10% of total applications, most of it arising from the low-income family portion, not the Long-Term Care portion.
Some operators also mistakenly believe that accepting Medicaid patients means facilities filled with low-income and the poor.
Indeed, many middle-income families also incorrectly assume that the asset and income limitations under Medicaid preclude them from enrolling at all and that they must seek, instead, long-term care or other insurance programs. This notion is fostered, in part, by long-term care insurance companies that obtain paying customers from these same mid-income families and by legislators trying to keep government costs down.
But Medi-Cal and private insurance are not mutually exclusive choices. Legislators in the states of California and New York recognized this and created "partnerships for long-term care" enabling individuals to use both private insurance and Medi-Cal. In truth, Medicaid, has become the nation's prime long-term provider, with various rules and regulations that must be met in order to receive benefits.
The Myth of Medi-Cal Paperwork
Medi-Cal does involve complex rules and requirements, and federal licensing standards are strict, requiring higher ratio of skilled to non-skilled personnel. The licensing procedure itself can take up to three years to complete. And the billing process is more complex, requiring documentation to back up costs for services.
Well trained providers have no problem with billing or payment.
Ask the Expert
Dear Expert:
My parents have several properties in addition to their home. My dad needs Long-Term Care. Could they qualify for Medi-Cal, for dad?
— Skeptical in Saugus
Dear Skeptical in Saugus
The number or value of assets will not prevent eligibility for your dad; only poor advice and implementation.
Call us for assistance - (800) 773-6467.
Send your questions to Ask the Experts.
