Quality Home Health Care

Choosing Between Medicaid and Medicare

Medicare or Medicare?

Medicare or Medicare?

As we age, which program is better – Medicaid or Medicare? In order to answer that question, we need to define each program. What does Medicaid do? What does Medicare mean?

Medicaid is a government sponsored assistance program that helps low income families and some individuals pay for their health care. The Medicaid program is state run, but funded half by the state and half by the federal government. The federal government may contribute less in a state that has a wealthier population. As a state run program, Medicaid’s eligibility guidelines vary state to state, as does the type of coverage. To be eligible for this program, you must have $1,000 or less in liquid assets. The amount of help you receive from Medicaid is based on a sliding scale. The more income an individual or a family has, the less Medicaid they will receive. Some states require beneficiaries to pay a co-payment or deductible to their health care provider for medical services provided, although in some states the co-pays can be as little as $30.00 per month.

Medicaid covers chronic conditions as well as long term care, and Medicaid covers a wider range of health care services than Medicare does. Medicaid pays for x-rays, pediatric care, hospitalization, clinic treatment, laboratory services, family planning, surgical and medical dental care, and in-home nursing facilities for those over 21 years of age. 60% of nursing home residents’ health care expenses are covered by Medicaid.

Medicare is a federally run and sponsored program.  Unlike Medicaid where coverage can vary from state to state, all coverage under Medicare is uniform nationally. Eligibility for Medicare only requires that you be over 65 years of age and have paid taxes into the Social Security fund at some point in your life.  Income does not factor into your eligibility for Medicare.  People who are suffering from end stage renal disease or disabled individuals who are receiving or are eligible to receive Social Security benefits are also eligible for Medicare.

There are different divisions of the Medicare program: Parts A, B, and D. Part D covers prescription drugs, Part B covers medical insurance and Part A covers hospital care such as nursing facility stays, hospice care, respite care, and inpatient hospital stays.  All of these are included under the acute care umbrella. It is important to note, however, that Medicare is not a long term care program, so it does not cover chronic conditions.  Regardless of the type of Medicare that you receive, co-pays or deductibles for certain medical services may be required under Medicare and Medicare reserves the right to refuse to pay for medical treatments that it deems unnecessary.

So given all of that information, how do your health care needs compare to the services provided by Medicare and Medicaid?   Making the decision between the two coverage options is not easy.  You should always consult with health care professionals regarding your choice, and request as much information as possible from the government regarding each program to determine which is the most suitable for you.

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Who’s Who in Elder Care – Home Care Services?



Beyond the Primary Physician and Specialists, it can take a village to help older adults, our aging parents to remain safe and largely independent in their own homes. Additionally, it is rudent to plan ahead for the possibility that they may not be able to remain in their own home.

 Where to start in the Elder Care Maze? Either with someone you know, has been highly recommended to you or whom you have vetted.

Well it does depend on your individual situation, health, family, finances and the like. Certainly if you or an elderly loved one has a degenerative disease – physical or cognitive – you will do best to plan early for services and care down the road. Care costs!

Do you or your spouse have Long Term Care insurance? Can you qualify?

Any thoughts to where you want to grow old? Up North, in Florida, near family, a home with stairs or without etc?

Remember, homes can be modifie for safety and ease – where do you have more supports?

We will assume that you have your doctors and specialists to manage your health needs.

Do you have a financial planner?

Have you met with an Elder Law Attorney?

Do your folks live far away and you don’t really know what is going on – have you spoken with a Geritric Care Manager who can visit, assess and create a care plan for your parents?

When planning and managing things for a senior adult, Boca Home Care Services recommends dealing with Elder Care Professionals.

This is especially true about Financial Planners who would need to be expert in Veteran’s Benefits, Medicare and Medicaid. Some government benefits may cancel out eligibility down the line for other government benefits. Also to discuss Reverse Mortgages.

An Elder Law Attorney will be best able to handle Durable Power of Attoreny, Medical Surrogate and Directive Forms, Trusts and Wills. Laws are always changing, it will pay in the long run to use and Elder Care Professional.

Home Care could easily be needed either intermittently due to accidents, falls or post surgeries, or long term due to disease or disability. Go with a licensed company.

Home Care Aides will assist with personal care (bathing, dressing,Toilieting, walking) – the Activities of Daily Living and household chores like; cooking, shopping, laundry and driving.

Medicare Home Health Care may also be in your future if for a series of reasons you would require the in home services of a Registered Nurse, Physical, Occupational & Speech Therapist, Medical Social Worker or bath visits.

You have likely planned ahead for many parts of your life, where to go to school, when to marry and start a family, career moves and retirement. Due to our amazing jump in longevity today, Retirement can be 20 or 25 years ago.  Don’t stop now to plan ahead. Seek the counsel of experts in the areas you require.

Consider health and family support situations as they may be in the future. You will want to maintain your lifestyle and independence. Today with the advances in technology, there are so many gadgets to help people achieve the safety and comfort in their own home. There are monitoring devices, mobility equipment, medication dispensors and lots of things to help insure the security of folks with Alzheimer’s Dementia.

Use the services and conveniences around you. So much better to have a plan and not need to use it than have the need and no plan!



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Medicaid is a Federal Program In Which Funds are Distributed by the States – i.e. Nursing Home Care


Once a person, a loved one or yourself needs Nursing Home Care you may not be physically or mentally capable of understanding how to apply for Medicaid or you may not be eligible. There are many things to learn when planning for old age. Financial planning is key to enable you to maintain your lifestyle and in event of medical need, afford the kind of help you require either at home or in a long term care facility. Boca Home Care Services explains some pieces of the puzzle and strongly recommends you explore these things on your own before you need them.

We don’t have a crystal ball but can deduce some things about our future. We can look at our genes and what our parent’s old age looks like. We can examine our own medical and financial profiles. We can explore what services are out there and what the criteria are for Governmental programs which presently pay for Nursing Home Care, or some in-home assistance (community or home diversion programs).

The government, via Medicare, Medicaid and Social Security covers a huge part of many American’s medical and living expenses. Philosophies aside, we are growing older than ever before and therefore the number of us who will need assistance with our care is growing as well. Personal wealth, and insurance are needed and may be enough not to require other funds. We believe in planning and hope you will investigate the financial outlook for yourself or your parents once the 80s role around.

Medicaid is a primary payer for nursing home care. However you can’t just decide one day to apply. There are financial requirements and a look back period. In Florida it is between 3-5 years. Meet with or speak with your financial planner, elder law attorney and figure out what is best for you.

Explore Medicaid now when you or your family member doesn’t need it. It is a usual and common question we get, “How do we get on Medicaid so they pay for it?” At least get acquainted with some of the basics of Medicaid if you have any chronic and/or degenerative illnesses.

You may wish to go online to the Medicaid sites for your area, visit an office, find a specialist or an organization which works on Medicaid applications. In short, make it part of your financial planning homework.


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65, 75, 85 When Do You Start Planning for Your Old Age?

We plan for our Retirement at 65 but realize we may live till 95– what happens in between to help us maintain our lifestyle in the face of advanced age, possible health problems and finanncial concerns.  Boca Home Care Services urges  all Boomers and aging or elderly Seniors/Retirees to keep planning. We provide education, referrals and of course, Home Health Care.


So many people plan for their retirement. Sixty Five has been a target for a long time. When Social Security and Medicare were passed,  that basically matched an American’s life expectancy. Now we can live well into our nineties, well past retirement or even a post retirement period. How do you make a life plan for the last DECADES of your life rather than the last years?

A caller phoned today stating her 93 & 94 year old parents have nearly used up their $100,000 line of credit from their home – on home care. (Too bad they didn’t call us $75,000 ago) The daughter wanted to know what to do. Her mother went into Hospice in seven months ago and is living with end stage cancer. Her father will not separate from her. They had always been independent and stubborn. They figured their six children would take care of them – those children are now in their sixties, some with health problems of their own.  What they didn’t figure on, was living so long.

Neither is a war Veteran, their house is worth under $100,000 and they want to remain at home. There are a few people who can help, the Hospice Care Manager, a Geriatric Care Manager, a Financial Planner with expertise with Seniors, an Elder Law Attorney, Medicaid– Community Diversion Program and the family. They certainly need a specialst who can help them understand the limited resources available, the intricacies of the Hospice/Medicare/Medicaid system and how they may or may not overlap.

At Boca Home Care Services we urge people to plan, plan and plan ahead for their post, post retirement. A time when their health may be most compromised and their resources depleted. Invest in a Financial Planner and Elder Law Attorney. Learn what is possible and what may not be. Even most Long Term Care policies are just for a few years today. Living between the ages of 85 and 95 is a real possibility now, imagine how much further we Boomers can go.

So pick your number – 70- 75- 78- 80-82… whatever it is make it sooner rather than later. Put that stubborn streak to work for you– be stubborn about having to move out of your home because you can’t afford it any longer. Be stubborn about keeping your quality of life as close to what it is now as possible. Be stubborn about maintaining your independence by planning, not reacting to circumstances that you could/should have anticipated. We can see that our parents are outliving  ages that they thought was even possible. Be stubborn about planning your lifestyle as you head towards 100.

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Aging & Elder Services Directory for Florida

 Learn more about the many services  for Seniors, especially in South Florida. Read in place, a list of contact information for various organizations assisting our elderly citizens. From Benefits, to planning to in home care, a directory made easy for you and your aging loved ones.

Today we can do a computer search for most anything imaginable. So much so that the overload of information can render it all too confusing to be of use. Since Boca Home Care Services (non-Medical Home Care company) and Boca Home Care (Award winning Medicare Home Health agency) serve seniors in South Florida we’d like to share a basic list of mostly governmental services to our retired citizens.

Administration on Aging- U.S. Dept. of Health & Human Services: 222.aoa.gov 800-677-1116, 202-619-0724

Area Agency on Aging – http://ElderAffairs.state.fl.us/english/aaa.php — for most anything to do with Senior Services in Florida.

Emergency Management- Fla. Dept. of Community Affairs – www.FloridaDisaster.org

Fla. Agency for Health Care Adm. – http://ahca.MyFlorida.com – Home Care unit 850-414-6010

Fla Agency for Persons with Disabilities – http://apd.MyFlorida.com –  866-273-2273

Fla. Dept. of Elder Affairs  http://ElderAffairs.state.fl.us – Elder Helpline – 800-963-5337

Fla. Dept. of Financial Services – www.fldfs.com  800-342-2762

Florida Hospices & pallative Care, Inc. www.FloridaHospices.org – 850-878-2632 or 800-282-6560

Home Care Association of Florida – www.ahhif.org – 850-222-8967

Medicaid – to apply- www.MyFlorida.com/cf_web

Medicaid – General Info – http://ahca.MyFlorida.com

Medicare – www.Medicare.gov  – 800-633-4227

Medicare Home Health – Boca Home Care – www.bocahomecare.com 5561-989-0441

National Association for Home Care & Hospice – www.nahc.org – 202-479-1200

Volen  Center – Senior Center, Day Care and more- www.maevolen.com – 866-711-6872

Ruth Rales Jewish Family Services – Older Adult Programs – www.ruthralesjfs.org – 800-393-5397

Spectrum Planning Group – Financial Planning  – www.SpectrumPlanningGroup.com  – 800-545-1520

Boca Home Care Services – Home Care / Care Management –  – www.bocahomecareservices.com – 561-98-0611 or 877-706-0785

New Lifestyles Guide – Assisted Living Facilities and Nursing Homes – – www.NewLifeStyles.com – 800-869-9549

Alzheimer’s Association – www.alz.org/seflorida – 800-861-7826

Veteran’s Benefits – http://www.vba.va.gov/VBA/ – 800-827-1000

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