Does Medicaid pay for assisted living?

  1. Molly Dworken 10/16/2012 05:33PM

    Medicaid is a federal and state government-funded program that covers payment for certain inpatient and outpatient healthcare services for low-income seniors and others with very limited assets. Most states administer Medicaid programs individually and can have different guidelines regarding eligibility and coverage. In most states, Medicaid also pays for some long-term care services in the home or the community. Eligibility is usually based on income and personal assets. Your state government website or office will have information about determining if your income level qualifies you and how to go about applying for Medicaid.

    Much like Medicare, Medicaid does not usually pay for what is considered “non-medical” long-term care, which is what is found in most assisted living facilities. Medicaid does often cover most long-term care if it is in a skilled nursing facility or if the patient receives home health care services, such as physical therapy after hospitalization or surgery.

    Recently, there have been some changes in how states view and determine Medicaid coverage for assisted living facilities. As the cost of skilled nursing care increases, some states see assisted living as a cost-effective alternative to long-term care in skilled nursing for those less seriously ill seniors. As of 2012, 44 states offered some level of Medicaid assistance for assisted living care, usually in the form of waivers. However, there are enrollment caps to regulate how many people may receive assistance at the same time and there are often waiting lists. If you are researching whether your state will allow Medicaid funds to cover assisted living, ask if they have a waiver program.