Does Medicaid Cover Assisted Living?Does Medicaid Cover Assisted Living

Long-term care is expensive. The national average for a year in assisted living is over $43,000. And nursing homes clock in even higher at over $90,000. Even families that do their best to save for retirement often have a hard time shouldering the costs of assisted living and nursing home care.

While Medicare kicks in for retired seniors to help with many types of healthcare costs, it doesn’t cover the kinds of long-term care stays many seniors need.

In some cases though, Medicaid can help.

Who Qualifies for Medicaid?

First things first, you have to qualify for Medicaid for there to be any chance of the program helping out with the costs of long-term senior care.  If you did a good job of saving up for retirement, then there’s a pretty good chance you won’t qualify.

The specific rules for Medicaid eligibility vary for each state, but most of the people who may be able to tap into this resource for help with their assisted living expenses will:

  • Have medical or care expenses that are larger than your income
  • Be putting most of the income and assets you have toward paying for your care
  • Have a doctor who says a long-term care stay is medically necessary
  • Choose a facility that accepts Medicaid

Be aware that the government does pay attention to what seniors and their spouses do with their assets before applying for Medicaid for long-term care. If you try to make sure it looks like you have almost nothing in order to qualify by gifting your kids with most of your money and property, you’ll incur a penalty or be denied, so don’t try to game the system.  

If you have a spouse, they will be able to hang on to your home and enough money for living expenses without that counting against the amount the spouse needing care is seen as having though. If you find the guidelines confusing and feel you need some help navigating everything, you may find it worthwhile to talk to a financial advisor or someone in your local Medicaid office for more information.

If you really are in a position where the need for government assistance to cover the costs of an assisted living or a nursing home is a necessity, then Medicaid may make the difference in being able to get the care you need.

Other Resources to Help Cover the Costs of Long-Term Care

Most people won’t qualify for Medicaid. The rules are pretty stringent and your straits have to be pretty desperate before the program will step in to help. Other seniors may be able to take advantage of other sources to help cover the costs though.

Veterans Benefits

If either you or your spouse is a veteran, you have an extra store of resources to tap into for help with senior care costs. For many senior veterans, the aid and attendance benefit goes a long way toward helping put a dent in assisted living costs.

Long-term Care Insurance

If you already need long-term care by the time you’re reading this, then it’s too late to take advantage of long-term care insurance. If you’re still a few years away from needing that level of care, then look into investing in long-term care insurance now. The sooner the better. It can go a long way toward covering the costs when the time comes.

Even if you do qualify for one of these, it won’t exactly be a magical solution. You’ll still likely have expenses you have to pay out of pocket. Talk to your family about your options and weigh the various costs and benefits. It’s not an easy process to undertake, but it’s an important one to ensure you and your loved ones are able to receive the care required at the time it’s needed.

Kristen Hicks is an Austin-based copywriter and lifelong student with an ongoing curiousity to learn and explore new things. She turns that interest to researching and exploring subjects helpful to seniors and their families for SeniorAdvisor.com.

5 Comments

  1. Jim in Oceanside CA April 2, 2016 Reply

    Qualifying for Medical is not the real issue. Finding a decent facility that accepts Medical is.

    • Catherine October 25, 2016 Reply

      That is exactly the problem we are facing right now….Finding a decent facility that accepts medical. If you have any suggestions or can steer me in the right direction, I would greatly appreciate it.

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