Does Medicaid Pay for Assisted Living?

Today, more senior Americans are choosing assisted living communities sooner so that they can maintain a healthy lifestyle and enjoy the opportunities that community living offers. However, it’s no secret that assisted living can cost a pretty penny. The average expense of living in an assisted living community is $4,000 a month. But, does Medicaid pay for assisted living?

Does Medicaid Pay for Assisted Living?

What is Medicaid?

Medicaid is the leading government assistance program for long-term care coverage. It is a safety net for individuals who can’t afford care when they need it without a little assistance. The majority of funding for Medicaid comes from the U.S. government. In order to qualify, you must:

• Have income that falls below your state’s Medicaid income and countable asset limits
• Reside in the state in which you desire to receive benefits
• Be a permanent resident of the U.S. or have U.S. citizenship

Determine Your Medicaid Eligibility

Though Medicaid may vary by state, federal law mandates that each state cover certain populations. For example, people with disabilities are required to be eligible for Medicaid in every state. 

If you are a senior looking to finance your long-term care, you may qualify for Medicaid. Eligibility for individuals over 65 is determined by Supplemental Security Income (SSI), with guidelines determined by the Social Security Administration. If you are over 65 and do not have a disability, you may need to show that care is necessary, and the cost of care exceeds your income. You may also be eligible for a spend-down program that allows qualified individuals to receive limited Medicaid benefits.

Each state has specific guidelines, so it might be a good idea to contact your state’s medical assistance office for details. You can also contact an elder law attorney to help guide you through the challenges of a Medicaid application.

Medicaid and Assisted Living

While Medicaid coverage is determined by each state, most states cover some degree of long-term care. Medicaid may cover some costs of assisted living, such as:

• Long-term care provided by an assisted living community
• Inpatient and outpatient hospital services by Medicare
• Home health services
• Prescription drugs
• Physical, occupational, or speech therapy
• Eyeglasses
• Hearing aids
• Personal care services
• Hospice

Other Supplemental Living Cost Options

While Medicaid offers a variety of options to help pay for assisted living, there are many who still need additional resources to cover their cost of care. Lots of Americans find themselves having to turn to alternative methods and personal savings. For example, some insurance companies allow customers to use life insurance to pay for long-term care.

Wondering if your parent or spouse might be ready for assisted living but don’t know what the next step is? Check out our free eBook, Assisted Living and Older Adults!