Nurse and Old Lady with Caption "Long Term Care"


Laura Blumenstiel Jan. 2, 2024

A long-term illness or disability can bring about financial uncertainty, especially considering the high cost of healthcare. Long-term care insurance and Medicaid are two options that individuals can consider to cover their long-term care expenses. This article aims to provide you with a comprehensive understanding of what long-term care insurance and Medicaid are, and the differences between the two.

Long-Term Care Insurance

Long-term care insurance is a policy that covers the expenses associated with long-term care, including nursing home care, home care, and assisted living facilities. It is a type of insurance that is designed to provide coverage for medical and non-medical expenses, which are not typically covered by regular health insurance.

The policyholder must pay a monthly premium to be covered under a long-term care insurance policy. The premium amount is determined based on age, health, and policy coverage. The policy coverage can range from in-home care to nursing home care.

It's important to note that the sooner you apply for long-term care insurance, the lower the premium usually is. Generally, it is recommended for individuals who are in their 50s and 60s to obtain long-term care insurance while in good health, to take advantage of lower premiums.


Medicaid is a joint federal and state program that covers healthcare costs for individuals with limited income and assets. It provides coverage for people of all ages, including long-term care for seniors and individuals with disabilities. Medicaid will cover long-term care expenses, typically in a nursing home setting, for those who meet the income and asset requirements.

To qualify for Medicaid, you need to meet certain eligibility requirements. Your total income and assets, including real estate, bank accounts, and investments, will all be taken into consideration. Medicaid also has a five-year “look-back” period that considers any assets that you gifted to others in an attempt to lower your assets quickly before applying for Medicaid.

What's the difference between long-term care insurance and Medicaid?

The key difference between long-term care insurance and Medicaid is how they are structured. Long-term care insurance is a private insurance policy that is purchased to cover the costs of long-term care (such as in-home aids and nursing home expenses). It is available to anyone who can pay the monthly premiums and will cover the costs of care regardless of your income or assets.

Medicaid, on the other hand, is a government-run program that provides healthcare coverage to those who meet certain eligibility requirements. While long-term care insurance is typically geared towards those with high income and assets, Medicaid is designed for those with limited income and assets.

Which option is right for you?

Choosing between long-term care insurance and Medicaid depends on a variety of factors including your age, health, and financial situation. If you are in good health and can pay the monthly premiums, long-term care insurance may be a good option. However, if you don't have the financial means to afford long-term care insurance or meet the asset and income requirements set by Medicaid, then Medicaid may be the better option.

If you are still unsure which option is right for you, it's best to consult with an experienced estate planning lawyer with experience in Medicaid matters. They can provide you with a better understanding of your options and help you make the best decision for yourself and your loved ones.

While long-term care insurance and Medicaid both provide assistance in paying for long-term care, there are differences in how they are structured, how costs are covered, and who is eligible. Ultimately, choosing between the two is a personal decision best made with the help of an experienced elder law attorney. Give us a call at 614-389-9711 to schedule an appointment and discuss your options.

Want to learn more about long-term care and Medicaid planning? Check out our free downloadable e-Book, Aging with Confidence.

About the Author

Having earned her law degree in 1997, Laura Blumenstiel has nearly three decades of legal experience. She is deeply committed to providing compassionate and effective legal services for our clients. Each day, she finds fulfillment in meeting with clients and meticulously crafting trusts and estate planning documents. Additionally, she works diligently on estate administration through probate court proceedings. She's passionate about helping individuals and families plan for the future and guiding them through the probate process during difficult times. She strives to make a genuine connection with all her clients.