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Does Medicaid pay for assisted living?

3 answers | Last updated: Apr 02, 2015
Q
Janet asked...

If my mother can no longer afford assisted living, does she have to move out or is there a program we can apply for to keep her there? Does Medicaid pay for assisted living?

 

Answers
Caring.com User - Joseph L.  Matthews
Caring.com Expert
A
Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
81% helpful
Joseph L. Matthews answered...

Medicaid is the federal program, administered individually by each state, that provides medical benefits for seniors and others with low-income and few assets. In every state, Medicaid pays the full See also:
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cost of care in a nursing facility for someone eligible for the program. There's no Medicaid rule that requires a state Medicaid program to pay for assisted living, and most states don't cover it. But a few states have realized that assisted living usually costs much less than a nursing home. So, the state Medicaid program saves money if some people live in assisted living instead of nursing homes. If your mother is eligible for Medicaid and she lives in a state where Medicaid covers assisted living, she might get coverage for the place where she's now living. First, she has to apply for Medicaid coverage through her local county human services or social services office. She'll have to show her financial records, proving that she has a small income and few assets. If she qualifies for Medicaid and her state covers assisted living, the next question is whether the place where she's living is certified to receive Medicaid payments. If so, Medicaid may be able to pay for her to stay there.

If your mother is eligible for Medicaid coverage of assisted living but the place where she now lives doesn't participate in Medicaid, you'll have to help her find a different assisted living residence that accepts Medicaid payments. If her state doesn't cover assisted living at all, you could help her find a Medicaid-certified nursing home that looks and feels something like her assisted living facility.

 

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22% helpful
rtilkens answered...

Not really an answer, but comment. . . .

This was very helpful. My mom is in Assisted Living, and i know that "medicaid waivers" are available if your income is no less that 300% of SSI payment.

In her case, she makes more than this, but could be (in 3 to 5 years) not able to pay rising costs.

I don't think she needs a Nursing Home at this point, and i need to investigate whether our state (Md) is one where Medicaid is accepted (relinquish all your income and the State makes up the difference). We certainly have no problem with that.

 

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An anonymous caregiver answered...

These needs to be stated based on what Joseph said. Medicaid does NOT pay for the full cost of care of someone residing in a nursing home. The Medicaid participant pays what is called a share of cost for that care. That share of cost is based on the participants income and there are many other factors that also go into what the share of cost is. To receive the best answer, you should go into your local Health & Welfare office and ask to speak with a worker who helps those in applying for nursing home, assisted living, certified home care, or in-home care. Also, Medicaid income limits change for people based on their living situations and needs. You can have a nice monthly income of over $2,000 gross and still meet Medicaid income limits depending on the type of assistance you are needing. Of course, these limits and rules vary by State. I would always advise a person to go directly to their local Health & Welfare Office or speak with an elder law attorney in your State.