When you think of assisted living, it does not have to be paid from your earnings. Finding the right care for yourself or your parents may be an uphill battle, especially regarding assisted living costs. Many families concern about how they’ll afford it and whether their loved one will receive the required care.
Luckily, you got Medicaid, a health insurance program that helps people with limited income and helps pay for healthcare. It is the top government aid program for assisted living and long-term care. But the question is, does Medicaid cover assisted living? Now let’s examine it more closely.
The amount of money provided by Medicaid depends on various factors, such as,
- The state where you live
- The state-run program.
- Required level of attention
A requirements analysis is usually necessary to determine how many hours Medicaid will pay for. For example, people needing more help can receive more carer hours each month.
What assisted living costs does Medicaid cover?
Since Medicaid is health insurance, it covers all health care expenses, whether long-term or short-term. The notable thing is each state has its own rules and regulations to be followed regarding Medicaid.
At the same time, it is significant to note that it does not cover room and board but includes the following services.
- Long-term care
- Hospital services (Inpatient and outpatient)
- Homemaker services (ex – meals, laundry & housekeeping)
- Therapies such as physical, occupational, and speech
- Providing eyeglasses and hearing aids
- Prescription of drugs
- Medicare does not cover co-payments for hospital stays and specialized nursing care.
How to apply for Medicaid?
To apply, you should need some eligibility criteria, such as
- Your income must meet the state’s Medicaid income limit, or your medical care expenses should exceed your annual income.
- Their possessions that can be counted must be within reasonable bounds.
- You must be a state resident from where you want to receive benefits.
- You must have the precondition medical need.
However, each state has its own guidelines and eligibility criteria. So if you want to apply, it is better to contact your state’s medical assistance office for further details.
Alternatively, you can consult with an elder law expert who can assist you with Medicaid application requirements and benefit eligibility.
What Are Medicaid Asset Limits for Nursing Homes?
States limit the number of assets you can own and still be eligible for Medicaid in addition to a salary limit. The exact asset varies between states, but for many states, it’s more likely $2.000.
In foreign countries, the asset limit is significantly higher. In this case, it is good to check with your state’s health services department to determine the specific limitations in your state.
Some notable things need to be excluded from the asset while tallying. You can leave the followings,
- A car
- Belongings from household and personal
- One wedding and engagement ring (any value)
- Pre-paid funeral expenses
- Insurance policy
- Your home (If your partner, a young child, or a child who is blind or disabled lives there, or if you plan to return there.)
Medicaid Benefits for Assisted Living
The average monthly cost for assisted living services in India is $4,283. For people who need assistance comparable to that found in nursing homes but would prefer to remain at home, the state provides a Home and Community-Based Services (HCBS) Medicaid Waiver.
Additionally, India assists people residing at home, in foster homes, or in supported living facilities through its Aged and Disabled (A&D) Medicaid Waiver program. The program also helps care home residents who want to return to their homes. A carer for the aged or disabled person is provided under the waiver program’s Structured Family Caregiving benefit.
Comparing Medicaid vs. Medicare in assisted living
The government provides health coverage through Medicare and Medicaid programs that are completely different.
Medicaid is an “old-age assistance” program. It is available to a limited number of people who meet fixed income and the guidelines of the asset (or women who are expecting a child or those with certain specific conditions). Medicaid is designed to provide healthcare to low-income and asset-holding individuals but also requires high medical bills.
Another interesting news is it is a joint state-federal program. That is why each state can start and operate its own Medicaid program independently and offer half of the fund. The remaining half will be provided with federal money, and the state Medicaid systems should follow the guidelines mentioned by the national.
Medicare is regarded as a “benefits” program. Everyone who has turned 65, is chronically hindered, or has an end-stage renal disease is suitable to start getting social security benefits. As a result of work taxes, they have accrued these benefits throughout their lives, which entitle them to Medicare benefits as well.
Only those over the age of 65 or those who satisfy certain disability requirements are usually eligible for Medicare, a government program that provides benefits for medical and hospital expenses. There are very few retirement homes and home health services available.
What does Medicaid cover long-term?
Among the most significant payers of long-term care services is Medicaid, which covers not only ongoing medical expenses, such as medical appointments and hospital stays but also:
- All qualified individuals older than 21 may receive long-term care services in nursing facilities, including custody.
- Nursing care and personal care are included in home health care services for older people.
- Case management, personal care assistance, and laundry and housecleaning assistance are long-term programs available in the home and community.
Personal care and other service requirements are usually considered when determining eligibility for long-term care services. You may be eligible for assistance enabling you to receive in-home care or different types of care if your degree of assistance indicates that you should reside in a nursing home.
In conclusion, Medicaid can be a useful resource for people who need help paying for their assisted living expenditures, although it may differ by state and condition.
While it’s essential to research and understand your state’s qualifying requirements and restrictions, Medicaid can offer a much-needed safety net for people and families dealing with the challenges of aging or impairment with careful preparation and consideration.