Medicaid and Medicare for Assisted Living

Find out how you can get assistance with paying for your or your loved one’s assisted living costs.

Everybody is bound to get old and before even realizing it, you will be part of the senior citizens’ group. Therefore, this early, it will be an advantage to learn the various aspects of adult assisted living. One particular and more important area of concern is where you will be residing the moment you have reached this stage in life.

The retirement community is a flourishing concept. It provides for housing and other basic services for the elderly. It can be a detached facility that contains exclusive rooms or small houses that sit on huge tracts of land. Services may cover nursing aid and medical aid, laundry, food, activities and security. Assisted living apartments are also popular although the services are limited mainly to food provisions, transportation and security. Rent subsidy programs for older people who come from low to average income families are also alternatives although it requires longer waiting period to avail of the benefit from local housing authorities.

Can Medicaid and Medicare Cover the Cost of Assisted Living?

Federal health insurance (Medicare) is applicable for old people and qualified disabled persons. On the other hand, Medicaid is health insurance program administered by state governments for selected low-income persons, elderly individuals, disabled, pregnant women, and children. Medicare includes various medical services provided while staying at assisted living homes. However, this service does not encompass rooms, daily living expenses, miscellaneous activities, and caregiver functions. Medicaid answers for the expenses not included in Medicare at assisted living facilities.

It is necessary to get in touch with your state Medicaid office for enrollment purposes. There is the probability that your resources may go beyond the limits for Medicaid eligibility. Thus, you have to make use of personal resources such as bank accounts, bonds, and retirement plans. The money is meant for paying the cost of assisted living until you go below the resource limit and become qualified for Medicaid.

Make sure to check with Medicaid personnel office regarding your entitlement to Qualified Medicare Beneficiary benefits. This will answer your original Medicare payments, co-insurance and deductibles. QMB is readily available for people entitled to Medicare and Medicaid benefits. Request your primary care doctor for a letter explaining the medical prerequisites for assisted living services. This letter must contain detailed medical diagnoses that affect your ability to take care of yourself. Medicare and Medicaid require documentation of medical necessity before payment for assisted living communities is approved. Call your state Medicaid office to find out of all forms of paperwork which needs to be accomplished and submitted for approval. At the same time, get a list of accredited assisted living centers. You should choose an assisted living facility that is willing to accept Medicaid and Medicare as payment. If not, it is your personal responsibility to settle the full amount indicated in the bill. Keep in mind that the average cost of assisted living is approximately $1,800 for each month. This is a relatively big amount which may not be easy to manage so be resourceful in reaching out to all facilities in your list and determine their policies.