Does Medicaid pay for assisted living?

A fellow caregiver 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?

Expert Answer

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 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.