Assisted Living Costs, Medicare and Medicaid

It’s no secret that assisted living costs can stretch any family budget to a breaking point. In 2017, the Genworth Cost of Care Survey found the median cost for assisted living to be $3,750 per month, breaking down to $123 per day and $45,000 per year. Fortunately, Medicare and Medicaid are available to help pay for assisted living in certain circumstances.Assisted Living Costs, Medicare and Medicaid

Learn more about these two programs and how they may be able to help your family cover assisted living costs.

Medicare: Government Health Insurance

Medicare is a national, government-funded health insurance that all Americans receive upon turning 65 years of age. In some cases, disabled people who are under 65 can also enroll in Medicare with no premiums.

Medicare does not cover assisted living costs or long-term care but can cover short-term rehabilitation care at a nursing home after a hospitalization. It can also pay for rehabilitation services and in-home therapy in some cases.

It’s important to note that Medicare will not pay for the following types of senior living care:

  • Any long-term care services
  • Assisted living costs
  • Long-term care at a nursing home or senior living community
  • Residential care homes

Medicaid: Government-Assistance for Long-Term Care

In contrast, Medicaid is the leading government-assistance program for long-term care. Provided cooperatively by the federal government and the states, the majority of the funding comes from the U.S. government. Medicaid is essentially a safety net for senior Americans who can not afford the care they need without assistance.

Like Medicare, Medicaid acts as insurance but it covers nearly every type of healthcare cost and can be used to pay for assisted living costs and long-term care. While each state has its own rules and regulations, many states allow its residents to use Medicaid to cover assisted living communities and in-home care.

Medicaid eligibility requirements are as follows:

  1. Allocation of almost all your existing assets goes toward care.
  2. Low-income earners or people with medical-related care expenses that exceed their income.
  3. Must reside in the state where receiving benefits.
  4. Permanent resident or U.S. citizenship.

Note: If married, a couple does not need to have exhausted all financial resources. The healthy spouse can usually keep the home but may still have to make significant sacrifices.

Each state has its own guidelines, so it’s important to contact a State Medical Assistance Office for more details or contact an elder law attorney who can walk you through the nuances of a Medicaid application.

How has Medicare or Medicaid helped you pay for assisted living costs? We’d like to hear your stories in the comments below.

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