With both parents in assisted living, will Medicaid still cover costs?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

With both parents in assisted living, will Medicaid still cover costs? I want to put my parents in assisted living. My dad is eighty-five and has Alzheimer's. My mom is seventy-nine and can no longer care for him. They have a little savings but not a whole lot. It won't take long to spend down their money. If they go to assisted living and spend their savings down, the assisted living facility will accept Medicaid, if they qualify. I am sure my dad would qualify but my mom is still independent. What are the qualifications for Medicaid assisted living and would my mom be thrown out even if my dad qualifies? This is a scary question and worries me. I want to make this their final residence.

Expert Answers

In some but not all states, special Medicaid programs cover some of the cost of assisted living at participating facilities for people who qualify. It sounds like you have already learned that in your state there is such a program, and that the particular assisted living facility you are interested in for your parents participates in this special Medicaid program.

But there are several other considerations, too. Your parents must be financially eligible for this special Medicaid coverage, which means having very low income and few assets. And they must qualify in terms of the level care they need, according to their state's program requirements. Finally, even if they do qualify, the program is likely to pay only a portion of their total assisted living facility costs.

Here's a look at the different kind of limits that special state Medicaid programs impose on assisted living coverage. The specific rules are different for each state.
• Some programs only cover people who would require nursing home care if they were not in assisted living. From the sound of your question, your mother might not qualify if her state program has this requirement.
• Many programs pay for some personal care services provided by the assisted living facility, but not for room and board; others pay part of room and board costs.
• The amount the program pays may depend on the level of services needed. If your mother lives in a state with this rule, and she needs few services, the program won't pay much if anything for her.
• Some states cap monthly payments, regardless of how much care actually costs.
• In some states, only a small number of people are covered; in these states there's usually a waiting list.

To learn the details of Medicaid coverage -- often called the Medicaid home and community-based services (HBSC) waiver -- in your parents' state, contact the state's Medicaid office. To find the state's Medicaid Web site, go online to any search engine and enter "Medicaid" and the name of that state. Or, you can call the Eldercare Locator toll-free at 800-677-1116 and ask for contact information for the state's Medicaid office. The assisted living facility you are interested in may also have useful information for you about the extent of coverage and qualifying for it.