It’s important to determine how one plans to pay for long-term care. Medicare doesn’t cover payment of long-term services and supports. Usually, Assisted Living facilities (intermediaries between independent living and skilled nursing, often offering room, board, meals, and some assistance with daily activities of daily living) are paid for by one’s own funds and assets Long-Term Care insurance, depending on the plan selected, may pay for care at an Assisted Living facility or care at home, but one needs to check one’s policy carefully to determine what is actually covered, and if a particular Assisted Living facility is a coverable expense through one’s private LTC insurance policy. According to Does Long-Term Care Insurance Cover Assisted Living? in U.S. News and World Report, “In general, long-term care insurance is flexible along the continuum of care. It can pay for assisted living, a nursing home or adult daycare,” says Kelly Short, editor at SeniorLiving.org. However, she adds, some LTC policies are designated as facilities-only, meaning they won’t cover in-home assisted living services.”
For more about Long Term Care insurance, ConsumersAdvocate.org rates what it considers the best LTC services.
Caring, LLC is a lead senior care referral service that operates the website Paying for Senior Care, which provides excellent resource information in regard to “Financial Assistance & Funding Options for Assisted Living / Senior Living”.
The company also provides readers with a number of helpful tools, including an “Eldercare Financial Assistance Locator” tool.
Paying for Senior Care makes it possible for people to identify qualified, affordable home care, assisted living, nursing homes, memory care, adult daycare, and adult foster home by region.
For those who are lower-income and who qualify for Medicaid insurance, Medicaid (the health insurance program name varies by state) may cover at-home care and care at a skilled nursing facility. Medicaid recipients may apply for an Assisted Living Waiver (waiver names vary by state) to pay for care at an Assisted Living Facility; however, not all regions have or accept Assisted Living waivers to pay for Assisted Living, and unlike Medicaid for long-term care at a skilled nursing facility, which is an entitlement program, Medicaid waivers limit the number of people who can receive services, limit their services to certain regions, or to those with specific medical diagnosis, so one may be waitlisted for services. (Medicaid Planning Assistance, https://www.medicaidplanningassistance.org/definitions/#hcbs)
State Specific Medicaid Eligibility Requirements
- VA Aid and Attendance benefits and Housebound Allowance
- Veteran Directed Care (VDC) program
- Geriatrics and Extended Care
- VD-HCBS vs. Medicaid Cash and Counseling
- Veteran-Directed Care – Home & Community Based Services (payingforseniorcare.com)
- VA Homemaker and Home Health Aid Care
- VA Nursing Homes And Assisted Living | Veterans Affairs
“The Long-Term Services and Supports (LTSS) Technical Assistance Center guides American Indian and Alaska Native programs in planning and implementing programs to care for their elders and people with disabilities.”
The Eldercare Locator is a search tool one may use to determine which adult day programs are available in your area.
Alternatively, read our article about paying for assisted living with non-Medicaid sources of assistance.
Medicaid Assistance Estate Recovery (MAER) Medicaid’s Home Care Benefits, State by State offers care for those living at home, attending adult daycare, at-home care, home and community-based waivers and services, including assisted living waivers, the geriatric care management, and other services.
Multipurpose Senior Services Program (MSSP) operates under a Medicaid (Medi-Cal in California) 1915(c) Home and Community-Based Services (HCBS) waiver that has been approved by the federal Centers for Medicare & Medicaid Services.
Find a Medicaid Planner and Determine Medicaid Eligibility Status for U.S. seniors 65 and older who are interested in Medicaid for Long Term care services. MedicaidPlanningAssistance.org is a free service provided by the American Council on Aging.
Medicaid Eligibility Test / Pre-Screen for Long Term Care for U.S. seniors, 65 and older
State Specific Medicaid Eligibility Requirements
A Place for Mom has information about state Medicaid websites and Medicaid Waivers Directories
Home Health Care / Non-Medical Home Care PACE Programs are called LIFE Programs. PACE is an acronym for Programs of All-inclusive Care for the Elderly and LIFE is an acronym for Living Independence for the Elderly. PACE may be provided by Medicare and Medicaid beneficiaries in areas where the programs are located. They are not located in all states, nor in all regions of participating states.
Medicaid Long Term Care Eligibility by State