Assisted living and Medicaid, can be confusing, and it is difficult to know what is covered and what is not. Many people wonder can assisted living to be covered by Medicaid, the answer is yes, but there are plenty of different ways that it works.
The problem with Medicaid and assisted living facilities, is that it changes from state to state, and some homes do not accept it at all.
Assisted living costs can vary from state to state, from city to city, and it can vary on what style of assisted living community you are interested in.
Medicaid Benefits With Assisted Living Facilities
As Medicaid is funded by the Federal Government and spatially by the state, it can be difficult to know what is covered and what is not.
The guidelines are set by the Federal Government on how the states must spend their Medicaid money, but they give the states a lot of flexibility.
Each state will have its own guidelines and policies on how it will help seniors in assisted living facilities. There are also different types of Medicaid programs for paying for assisted living.
States will use the 1915c Medicaid HCBS Waivers, there are other types of waivers that states use, but the most common regular State Plan Medicaid is used for paying for assisted living services.
The Medicaid waivers will help families that have a higher income bracket, to qualify for the State Plan Medicaid program.
Medicaid Income Requirments For Assisted Living
The state income requirements will vary from state to state, but here are some general numbers for you, with the waiver the monthly income limit is $2,300 per month, and State Medicaid Plans may only accept income of u to $770 per month.
There are usually waiting lists for all state-specific plans, but Regular and State Plan Medicaid programs are an entitlement so they cannot limit enrollment, but, so it is important to review all of your state’s specific requirements, as they will only have a limited amount of availability.
Most states now do offer some financial help to pay for assisted living, but some states have different names fr assisted living.
Here are the other terms that assisted living homes may be called, residential care, adult foster care, personal care homes, supported living, personal care services, and nursing homes.
Limits with Medicaid And Assisted Living
States are not permitted to pay for room and board costs at an assisted living facility, but they can pay for other services to make u for it.
The state can limit the amount the residence can charge, some states can supplement Social Security benefits to help to pay for assisted living, and the state can pay for meal preparation and serving of the meal, but it cannot pay for the actual cost of the food.
Not all assisted living communities will accept Medicaid, and Medicaid may not be the best way for some families to pay for assisted living.
Medicaids reimbursement rates are not that high, and that is why some assisted living communities do not accept them.
A State By State Guide To Medicaid Coverage
With this guide, you will have a better idea of which facilities will take Medicaid, and you will know what Medicaid covers with assisted living, and how it works with assisted living.
Remember not all facilities will take Medicaid, so it is important to find out first what communities will accept Medicaid first.
Alabama: Alabam has a few programs to help seniors receive help in their homes, but it does not currently help to pay for assisted living.
Alaska: Alaska will pay for assisted living with the Alaskans Living Independently Waiver and the Adult Physical Disabilities Waiver, there is a waiting list for these services.
Arizona: Arizona will pay for assisted living with the Arizona Long Term Care System, it will pay for seniors living in assisted living homes.
Arkansas: Arkansas will pay for assisted living for Medicaid beneficiaries, the Living Choices Assisted Living Waiver is helpful. Also, the Independent Choices Program option with the state’s regular Medicaid can also help to pay for assisted living.
California: California has MediCal and this will help to pay for assisted living, using the Assisted Living Waiver. Not all counties will offer this, but California residents can choose any home within the counties that do offer it.
Colorado: Colorado has a waiver called the Elderly Blind And Disabled will help to pay for assisted living services.
Connecticut: In Connecticut, Medicaid pays for assisted living through the Home Care Program For the Elderly. Also, the Adult Family Living program will also help to pay for assisted living care.
Delaware: Delaware uses the Diamond State Health Plan Plus to help pay for assisted living facilities.
DC: The District of Columbia Medicaid program Elderly Persons With Disabilities Waiver will help with assisted living.
Florida: In Florida, it uses the Statewide Managed Medicaid Care plan to help with assisted living services.
Georgia: Georgia uses the Comunity Care Service Plan to help with the costs of assisted living facilities.
Hawaii: In Hawaii, it uses the Med-Quest to help with assisted living costs. Also, Adult Foster Care will help to pay for residential assisted living.
Idaho: There are three programs to help to pay for assisted living in Idaho, HCBS Aged & Disabled Waiver, Personal Care Services Program, and the Idaho Medicare Medicaid Coordinated Plan.
Illinois: In Illinois, they use the HCBS Waiver for Supportive Living Facilities to help to pay for assisted living community services.
Indiana: Indian uses Aged and Disabled Waiver to help people with their assisted living needs in Medicaid-approved facilities.
Iowa: Iowa uses the HCBS Elderly Waiver to help to pay for assisted living facilities., they also have the Health and Disability Waiver, as another option.
Kansas: Kansas uses the HCBS/ FE Waiver to help individuals to pay for assisted living housing and services.
Kentucky: Kentucky uses Medicaid and the Supports for Community Living Waiver, which covers adult foster care, which is assisted living.
Lousiana: Medicaid currently does not cover any assisted living costs, but the Community Choices Waiver, which will cover some costs of in-home senior care.
Maine: In Maine, there is no coverage for assisted living, but MainCare will pay for some in-home senior care.
Maryland: In Maryland, assisted living is paid for by Maryland Medicaid with the Community Options Waiver. Also Increased Community Services, and Community First Choice will also help to pay for assisted living.
Massachusetts: In Massachusetts, they use MassHealth to pay for assisted living facilities, with their Person Care Attendant program.
Michigan: In Michigan they use their Choice Waiver Program, to help pay for assisted living.
Minnesota: In Minnesota, they pay for assisted living with the Elderly Waiver. They also have the Community Access for Disability Inclusion Waiver. And the last option is the state’s Medicaid managed care program called MSC+ & MSHO
Mississippi: In Mississippi, they have the Assisted living Waiver to help individuals to pay for their assisted living needs.
Missouri: In Missouri, they use the Aged and Disabled Waiver for assisted living. They also have 2 other options, the State Plan Personal Care option and the Supplemental Nursing Care Assistance Program.
Montana: The Home and Community Based Services Medicaid Waiver will pay for assisted living in Montana.
Nebraska: Nebraska uses the Home and Community Based Services Medicaid Waiver to pay for assisted living.
Nevada: In Nevada, the HCBS Waiver will help pay for assisted living housing.
New Hampshire: In New Hampshire, the Choices For Independence Medicaid program will help to pay for assisted living for seniors.
New Mexico: To help to pay for assisted living facilities in New Mexico they use Centennial Care Community Benefit.
New Jersey: In New Jersey, the Medicaid program called Managed Long Term Services and Supports will help with assisted living costs.
New York: In New York, they have the Assisted Living Program which has about 4,500 units in assisted living communities. There is also the Assisted Living Program to help pay for assisted living.
North Carolina: In North Carolina, they use the Medicaid State Plan Personal Care to help to pay for assisted living.
North Dakota: North Dacota will use its State Plan Personal Care program to help to pay for assisted living.
Ohio: Ohio uses its Assisted Living Waiver Program to pay for assisted living. It does not cover the cost of room and board, the service is called MyCareOhio by Medicaid.
Oklahoma: Oklahoma Medicaid’s ADvantage Program Waiver will help to pay for assisted living services.
Oregon: In Oregon, they use the K Plan to pay for assisted living care, this does not cover nursing homes.
Pennsylvania: In Pennsylvania, Medicaid does not pay for people living in assisted living homes. They do provide personal care assistance through the Department of Aging Waiver and Community HealthChoices Program.
Rhode Island: Rhode Island has a program called SSI Enhanced Assisted Living which provides some financial coverage with assisted living.
South Carolina: South Carolina Medicaid under the Community Choices Waiver will provide financial assistance with assisted living.
South Dakota: South Dakota uses the HOPE Waive to help with the costs of assisted living.
Tennessee: in Tennessee participating homes will use the CHOICES in Long-Term Care Program to help with the costs of assisted living.
Texas: The STAR PLUS program with the Texas Medicaid program will prove financial assistance to assisted living communities.
Utah: In Utah, they sure the New Choices Waiver to help with assisted living expenses.
Vermont: In Vermont, they use the Choices for Care Medicaid Waiver for the costs of assisted living.
Virginia: Virginia does not have any Medicaid program to help with assisted living costs, but you can use VA Adult services if you qualify to help with the expenses.
Washington: In Washington, they have 2 programs to help with the expenses of assisted living with Medicaid Personal Care program and the Community First Choice program.
Wyoming: Wyoming uses Medicaid Community Choices Waiver to help with the costs of assisted living, but it does not cover room and board.
Conclusion For Assisted Living And Medicaid
We hope you have found this article helpful and now you have a better idea of where Medicaid will pay for assisted living, it might be helpful to have an Elder Care Attorney help you.
Contact Loving Assisted Living to find out what would be the best home for your loved one, we have a nationwide network for you, so you do not have to guess where would be the best home or the best place for your mom or dad,