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Norwood Estate Planning Lawyer > Blog > Elder Law > Estate Planning In Massachusetts: Three Key Things To Know About Medicare

Estate Planning In Massachusetts: Three Key Things To Know About Medicare


Most people have a general awareness that Medicare is the primary federal health insurance for people who are 65 years of age or older. As medical needs tend to increase as we age, understanding Medicare is key to estate planning/elder care planning. There are a lot of misconceptions about how Medicare actually works. Here, our Norwood elder law attorneys highlight three key things that you should know about Medicare as you (or your loved one) approaches retirement age.

  1. Medicare is a Complex Federal Health Program (There are Four Different Parts) 

It is a mistake to view Medicare as a single, comprehensive federal health insurance program for senior citizens. Instead, Medicare has a more complex structure. There are actually four different parts of Medicare—and each have their own eligibility standards and coverage criteria. Here is a brief overview of the structure of the system:

  • Medicare Part A covers inpatient hospital stays. For most beneficiaries, there’s no premium for Part A, given that they (or their spouse) have paid Medicare taxes for a certain period.
  • Medicare Part B covers certain doctors’ services, outpatient care, preventive services, and home health care. Unlike Part A, Part B requires a monthly premium. Though, it may be $0 for a person with limited income.
  • Medicare Part C is also frequently called Medicare Advantage. It is a form of supplemental private insurance coverage that is strictly regulated by the federal government.
  • Medicare Part D is prescription drug coverage. It requires an additional premium.
  1. You Can Designate a Medicare Representative (Best to Use in Conjunction With a Health Care Proxy) 

Navigating medical issues—and federal health insurance coverage—can be complicated, especially for an older or otherwise vulnerable person. You can fill out a form to designate another trusted person as your Medicare representative. By designating a Medicare representative, you authorize an individual to receive your personal health information, ask questions about your coverage, benefits, or appeal a decision on your behalf. To be most effective, this designation should be used alongside a health care proxy.  A health care proxy grants the person named in the document broader authority to deal directly with health care providers (hospitals, doctors, nurses, etc). 

  1. Medicare Provides Little Long-Term Care Coverage (Medicaid is the Program)

An often-misunderstood aspect of Medicare is its limitation in covering long-term care services. Many believe that entering retirement, Medicare will cover most of their health needs. This is rarely the case. Medicare may cover short periods of skilled nursing facility or home health care, but it does not cover long-term care, such as a prolonged period in a nursing home.

Instead, Medicaid is the primary federal health program that provides long-term care/nursing home care coverage. The key difference between Medicare and Medicaid is that the latter is strictly means-tested. Medicaid may require a person to “spend-down” their assets before qualifying for coverage. There are options available. Proactive planning can help you preserve your assets.

Contact Our Boston, MA Elder Law Attorneys Today

At Fisher Law LLC, our Massachusetts elder law attorneys help clients with the full range of elder planning issues. If you have questions about Medicare planning or Medicaid/Masshealth planning, we can help. Contact us today for your completely confidential consultation. We provide solutions-focused, personally-tailored estate planning and elder law services throughout the Greater Boston area.



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