Many aging individuals find that they are no longer able to live alone. Assisted living facilities are designed to offer the help seniors need, while still giving them a sense of autonomy and freedom.
The cost of a quality assisted living facility can be significant. For patients who don't have the financial resources required to pay their monthly costs out-of-pocket, Medicaid may step in and offer financial assistance.
Here are three important things that you need to know about Medicaid-eligible assisted living facilities so that you can navigate the application process successfully.
1. Medicaid Only Covers Some Assisted Living Costs
It can be helpful to know the types of assisted living costs that Medicaid will pay for as you evaluate various facilities. Medicaid is designed to provide financial assistance for the medical services administered in an assisted living facility. This means that you can expect Medicaid to help cover the cost of any memory care, skilled nursing, or emergency response services utilized within an assisted living facility. Room and board are not expenses that are covered by Medicaid, so you will need to foot the bill for these costs yourself.
2. Medicaid Coverage Amounts Vary
People often wonder how much Medicaid will contribute toward the cost of residing in an assisted living center. The truth is that there is no simple answer to this question. Medicaid coverage limits can vary based on many different factors. Each state administers its own Medicaid program, so coverage limits vary from one state to the next. Assisted living benefits are typically awarded based on need, so your coverage limits could increase or decrease as your health status changes.
3. A Needs Assessment Is Usually Required
In order to determine your eligibility and coverage limits, a Medicaid specialist will ask you to undergo a needs assessment. The primary purpose of this assessment is to evaluate the amount of care that you will need in an assisted living center each month. This need is converted into a measurement of the hours of services within an assisted living facility that Medicaid will cover. Both financial and functional needs will play a role in the needs assessment to ensure all Medicaid recipients are receiving fair and adequate coverage.
Don't let the cost of an assisted living facility prevent you from seeking the help you need. Work with your state's Medicaid eligibility specialists to access the financial assistance you will need to pay for your spot in an assisted living facility.