The second way involves a restricted social insurance undertaking. Both approaches would allow, and perhaps encourage, development of private insurance to augment these benefits. Building on the existing program. The first approach would expand coverage for low-income elderly under Medicaid and subsidize or encourage purchase of private insurance by those with greater means. A few states are experimenting with such a model.
Private insurance is kept affordable by covering only a limited time period.
Those who purchased insurance would become eligible for Medicaid after private coverage expired without spending down all of their assets. This preferential public coverage would be activated at later stages of the nursing home stay. In this way, insurance costs would be more modest and individuals would be protected throughout their nursing home care. But this approach has potential difficulties, including the apparant flaw that those considering private insurance may do so explicitly to avoid Medicaid dependence. A more promising alternative would be to expand Medicaid long-term care services.