Medicare vs Medicaid: What Omaha Seniors Need to Know

When planning for healthcare in retirement, understanding the difference between Medicare and Medicaid is essential. While both are government-run programs, they serve different purposes, come with distinct eligibility rules, and can impact how you pay for long-term care. Misunderstanding these programs can lead to missed opportunities and costly mistakes.

Let’s break down what “Medicare vs Medicaid” really means, and how working with a legal advisor, like Legacy Design Strategies, can help you navigate your options with confidence.

What Is Medicare?

Medicare is a federal health insurance program available to:

• Individuals aged 65 and older
• People under 65 with certain disabilities or conditions

Because Medicare is federally managed, it works the same across all 50 states, including Nebraska. Medicare is funded through two trust funds held by the U.S. Treasury, with money coming from sources like payroll taxes and congressional funding. People with Medicare pay for part of their coverage through premiums, deductibles and coinsurance.

Medicare is made up of several parts:

• Part A covers hospital stays, skilled nursing, and hospice care.
• Part B includes doctor visits, outpatient care, and preventive services.
• Part D provides prescription drug coverage.

Even with all these parts, there are significant gaps in what Medicare will pay for. It does not cover long-term nursing home care, which can come as a surprise to many Omaha retirees.

What Is Medicaid?

Medicaid is a joint federal and state program designed for individuals with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. Unlike Medicare, Medicaid coverage varies by state, which means Nebraska sets its own income and asset limits for qualification.

In Nebraska, as of 2025:

• Income must be below $1,304 /month
• Assets must be under $4,000

While these limits may sound strict, Medicaid offers essential coverage that Medicare does not—including long-term nursing home care and assistance with activities of daily living like bathing, dressing, and eating. Medicaid may also cover services provided in the home or community for those who are eligible.

Who Qualifies for Medicaid in Omaha?

To qualify for Medicaid in Omaha, you must meet both health and financial criteria:

• Health Qualification: You must need help with activities of daily living (ADLs), or have a condition like Alzheimer’s or dementia.
• Financial Qualification: Your income and assets must fall below certain thresholds. Married couples have different rules, and eligibility gets even more complex when assets are jointly held or gifted.

That’s why professional guidance is key. Mistakes in asset transfers or misinterpreting the rules could delay or even disqualify your Medicaid application.

Can You Have Both Medicare and Medicaid?

Yes. Some individuals qualify for both programs and are known as dual-eligible. In this case:

• Medicare typically covers doctor visits and hospital services
• Medicaid helps with long-term care and out-of-pocket costs not covered by Medicare

Being dual-eligible can offer comprehensive coverage, but coordinating the benefits between both programs can be complicated.

Why "Medicare vs Medicaid" Matters for Omaha Families

Healthcare costs in retirement can be significant. For example, nursing home care in Nebraska can cost several thousand dollars per month, even for a shared room. Many seniors worry about depleting their life savings to cover these costs.

Understanding how Medicare and Medicaid work—and which one pays for what—can help you preserve your assets while ensuring you get the care you need. The earlier you plan, the more options you have.

How Legacy Design Strategies Helps with Medicaid Planning

At Legacy Design Strategies, we help Omaha families prepare for long-term care with strategic Medicaid planning. Our attorneys guide clients through:

• Asset protection strategies to help meet Medicaid eligibility while preserving wealth
• Crisis planning if care is needed right away
• Spend-down strategies that comply with Nebraska Medicaid rules
• Use of trusts or annuities that may help shelter assets legally

One option, for instance, is creating an irrevocable trust, which removes those funds from your countable assets. Another is converting assets into a Medicaid-compliant annuity, turning them into income and accelerating eligibility.

Whether you’re planning years in advance or facing an immediate need for care, our team can help you make informed, legally sound decisions.

Don’t Wait to Start Planning

Too often, people wait until a health crisis forces them to act. But early Medicaid planning offers more flexibility and protection. The rules are complex, and every family’s situation is different—so having a trusted advisor makes all the difference.

If you or a loved one in Omaha are concerned about long-term care and want to understand your options under Medicare and Medicaid, now is the time to act.

Schedule Your Consultation with Legacy Design Strategies

At Legacy Design Strategies, we believe in proactive planning for peace of mind. Our experienced team can help you understand your options, protect your assets, and prepare for whatever the future may bring. Request a consultation with a qualified Omaha elder law attorney to ensure your nest egg is protected from future long-term care costs.

Key Takeaways:

• Medicare offers nationwide coverage for people 65+ or with certain disabilities, covering doctor visits and hospital stays.
• Medicaid helps low-income individuals access healthcare, including services Medicare doesn’t cover, like long-term care.
• Dual eligibility provides added benefits, with Medicaid covering what Medicare doesn’t, such as nursing home care.
• Planning for healthcare needs now ensures financial security and access to the necessary care for the future.
• Consulting with an elder law attorney helps you navigate Medicare and Medicaid for personalized, long-term care solutions.

Reference: U.S. Department of Health and Human Services (Dec. 8, 2022) “What’s the difference between Medicare and Medicaid?”