Does Medicaid pay for Assisted Living? Medicaid is funded in part by the federal government and in part by the states. If you are confused about Medicaid, you aren’t alone. The Federal and State government are continuously changing rules surrounding healthcare, making it difficult for many people to know if they are using the correct information and making the right choices. Below, we’ve gathered some of the main benefits and drawbacks as well as some links to our vetted resources. Or, feel free to give our team at Stacys Helping Hand, Inc a call at the number above if you would like a Denver assisted living expert to help provide some clarity.
Does Medicaid Pay for Assisted Living
In Colorado, you can apply directly to Medicaid on your own, or you can choose to get Medicaid through the PACE program. In the Denver area, the program is called the InnovAge Greater Colorado PACE. We recommend utilizing InnovAge if the centers are conveniently located due to the fact that many of the assisted living facilities that don’t accept Medicaid will accept payments through InnovAge. The drawback is that InnovAge centers are in limited zip codes and require that you go through their network of experts. For difficult cases, you might need to talk to a local medicaid expert.
If you have limited assets, low income and you need help paying for nursing home or assisted living care, Medicaid might help you pay for part of your care. Nursing home and assisted living services are considered types of long-term care. Long-term care consists of not just medical services, but also personal services. For example, a resident in a nursing home might pay for assistance with bathing and dressing in addition to medical treatment. Medicaid rules for long-term care are significantly different in many ways than their rules for other services.
Medicaid may not be the best source of funding for assisted living depending on your situation. The first questions most often asked is whether Medicare will pay for assisted living. The answer is no. Medicare is strictly health insurance. Long Term Care Medicaid pays about 30% less than what’s needed for most assisted living costs. Medicaid will cover up to $2250 a month at most.
Since Medicaid reimbursement rates for assisted living facilities are not high, many assisted living communities don’t accept Medicaid. The ones that do are often shared living communities. Also, given the limited range of services for which Medicaid provides assistance and the enrollment caps and waiting lists for Medicaid waivers, many families might benefit by finding affordable assisted living outside of the Medicaid system.
For those who need help with assisted living in Denver, adults without dependent children whose household income does not exceed 133% Federal Poverty Level can apply here and will also need to apply for an Elderly Blind and Disabled Waiver (EBD Waiver). If they already have Colorado Medicaid Insurance, then they would apply for the Medicaid EBD Waiver. This waiver is what will contribute to covering the costs of assisted living.
We’ve written in more depth about the financial eligibility aspects of Long Term Care Medicaid (EBD Waiver) in Paying for Assisted Living Facilities: Spend Downs. In a nutshell, Long Term Care Medicaid requires you to contribute most of your income for room and board when you are living in an assisted living and the EBD Waiver will supplement the facility for your care. You are allowed to keep a small fixed amount of money as a “personal needs allowance” to pay for snacks, clothing and personal products.
There are spousal protection rules, but if you need that much detail, we’d recommend talking to a local expert. You can give us a call at Stacy’s Helping Hand, Inc at 720-620-3754