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Do Assisted Living Communities Accept Medicaid?

Do Assisted Living Communities Accept Medicaid

Key Summary

Wondering whether Assisted Living Communities accept Medicaid or Medicare? This article will help you understand what type of care is covered. Learn more.

If you have ever been a service member or struggled to complete requirements at the DMV, you know that government programs are often frustrating to navigate with a barrage of policies and processes to learn and comprehend. When data and federal Assisted Living costs and coverage criteria are thrown at someone seeking information on Assisted Living for the first time, it can befuddle even the most logical and analytical readers. We understand your frustration. Read on to determine the differences between Medicare and Medicaid programs, as well as what kind of care is covered when compared with Assisted Living Communities. Let’s start with some of the basics.

Does Medicare Cover Assisted Living?

Medicare is essentially an insurance program that’s primarily designed for those 65+ irrespective of their income. From the barrage of TV commercials we all see during their “sign up” period, it’s a program with multiple levels of participation that can be optioned in the same way you option levels of coverage and deductibles for your auto insurance. But remember, as someone turns 65 years of age, they are qualified for enrollment as of their birthday. The “sign up” periods are set up to add or change the various optional programs offered—and the premiums will vary depending on the coverage and deductible.

At its base level, Medicare pays for in-hospital costs and then goes into various other levels—the “Part A, B, C, D and Supplemental” they talk about in those TV spots—that can include a multitude of other medical provider fees. Most everything in this federal program will have a deductible cost that varies. By law, everyone is entitled to basic Medicare coverage and it’s managed by the Centers for Medicare and Medicaid Services (CMS) in Washington. You can learn more on the U.S. Medicare website.

What Assisted Living Facilities Accept Medicaid?

By contrast, Medicaid is an assistance program that’s a collaboration between the federal government and individual states for low-income patients or residents. Because states participate, there’s some variance (sometimes even in local regulations) as to what services are provided depending on where the recipient lives. Patients participating in Medicaid generally do not pay any of the fees involved, though in some instances a small deductible is required.

Therefore, federal and state-funded Assisted Living Facilities accept Medicaid patients who qualify. You can learn more on the U.S. Medicaid website.

Can Referah Help Me Find an Assisted Living Community if I’m in Either Group?

As a general rule, Assisted Living Communities are not covered by Medicare and Medicaid. This is due to the charter structure in addition to the way that state and federal agencies manage their programs and resources. However, there is almost always an opportunity for Referah’s experts to help! For example, many Medicare patients finish hospital stays and then seek Assisted Living services that correlate with what we have to offer. No matter the specific situation for you or your loved one, it can best be addressed by having a conversation with us. Even if Referah services are not what you need, we have plenty of information to point you in the right direction.

There is a lot to learn (and love) about Assisted Living Communities. Learn more about what to look for in our article “What are the Best Assisted Living Communities?

Benefits and Resources for Veterans

Remember at the start of this article, when we mentioned veterans? There are resources beyond or in addition to Medicare and Medicaid available for vets and their families. These options are best explored by contacting the United States Department of Veterans Affairs. Additionally, contacting fellow vets and drawing on their experience is often helpful. Many states operate Veteran Assistance Commissions where county-by-county directors are ready to help. Contacting your local Veterans of Foreign Wars (VFW) or American Legion post will invariably result in sound advice based on the experience of others who have walked this road before you.

VA Aid and Attendance benefits may also be used to help pay for Assisted Living. Benefits may vary based on several factors including when the veteran served, how long they served, financial need, and their need for care. This benefit is available to the veteran, their spouse (or surviving spouse), and qualifying children under the age of 18.

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