Financial Planning for Assisted Living
As of 2021, Medicaid pays for some of the cost of assisted living in 30+ states and the District of Columbia. Financial assistance from Medicaid for assisted living comes through several different Medicaid programs and is available to people with limited assets.
Medicaid and Assisted Living
The most common are Medicaid Waivers, also called Home and Community Based Services (HCBS) Waivers and 1915(c) Waivers. The number of states offering these waivers has increased rapidly in recent years, and assistance will possibly be available nationwide. However, some states are moving to a Medicaid managed care model and away from Medicaid Waivers. These states continue to provide the same benefits for assisted living but do so as part of their managed care programs instead of through waivers. In California, only some counties participate in the waiver program.
State Plan Personal Care or Personal Assistance Service, is a program where regular Medicaid benefits pay for personal care and allow beneficiaries to receive care in assisted living communities.
In general, States are increasing the level of assistance they offer to people in assisted living because this living environment is less expensive than skilled nursing homes.
Medicaid’s assisted living benefits are very inconsistent. For example, Medicaid pays for only personal care services in assisted living in some states. In other states, the size of the community is regulated. For example, some states limit size too small adult care homes.
In contrast, other states limit assisted living to larger residences serving twelve or more persons. Still, other states have no regulations related to the number of residents. Another variation in policy relates to room and board. While Medicaid does not pay for room and board, states have found ways to assist. For instance, some states limit the maximum amount charged or provide non-Medicaid assistance to Medicaid-eligible persons.
Please review your state’s eligibility requirements for whose Medicaid programs help with assisted living costs. Start here for California’s Medicaid Assisted Living Waiver program.
Veterans’ Programs for Assisted Living
There is financial assistance for assisted living for veterans in a pension called the Aid and Attendance Benefit. As of 2021, this program can provide assistance up to $1,936 / month for a single veteran and up to $2,295 / month for a married veteran.
Long Term Care (“LTC”) Insurance
Assisted living is primarily paid for by individuals’ private or personal funds, such as long-term care insurance or personal assets. Medicare does not cover long-term supports and services. Medicaid may cover some costs, but the rules vary by state. That’s where long-term care insurance comes in. Most LTC insurance policies cover expenses at an accredited assisted living community.
Elderlife Financial and Second Act Financial Services are the two organizations offering a loan products specifically designed as a Senior Living Bridge Loan. These Bridge Loans were created to help older adults and their families with the cost of assisted living, home care, or skilled nursing on a short-term basis. Periods typically range up to 12 months, but sometimes longer.