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Assisted Living Financial Solutions: Unlocking Medicaid’s Support

Assisted Living Financial Solutions: Unlocking Medicaid’s Support

Depending on where you live in the United States, monthly costs associated with assisted living average between $3,000 to almost $7,000. These costs vary by location but can also be affected by the level of care needed and the amenities offered at different assisted living communities.

Depending on where you live in the United States, monthly costs associated with assisted living average between $3,000 to almost $7,000. These costs vary by location but can also be affected by the level of care needed and the amenities offered at different assisted living communities. 

Fortunately, many financial assistance options are available for individuals and families to help defray some of these costs. Usually, families combine several different financial resources from both personal funds like retirement accounts and public assistance like Medicaid. It’s important to note that for seniors to pay for assisted living with Medicaid, they must choose a community certified with Medicaid, like all Solterra Senior Living communities. 

The below article will discuss potential financial solutions to help you pay for assisted living:

Medicaid Programs

Medicaid is a national program that helps provide health coverage for millions of Americans annually. Eligibility for Medicaid is largely income-based, but certain groups also qualify based on age or medical needs. Most Medicaid recipients are families with lower incomes, people with disabilities, pregnant women, children, and seniors. 

The federal and state governments work together to fund the Medicaid program and provide coverage to U.S. citizens. The federal government writes and oversees the program’s rules; all states must comply with those regulations. However, each state individually administers the program to serve its residents best. States can provide additional services or adjust some of the eligibility requirements to serve more people, and as a result, the Medicaid program is slightly different in each state.

Many states use a Medicaid waiver system to allow the most flexibility to determine what services and groups are eligible for coverage. Under this waiver system, states can choose enrollment levels to cap the maximum number of people that can enroll under each waiver.

Because the application process and understanding eligibility requirements can be daunting, connecting with a Medicaid planner can be a helpful first step. These program experts can walk you through the process and ensure you receive all the benefits you are eligible for. To help you access this resource, the American Council on Aging provides a free service to help you find a Medicaid planning professional in your state.

Medicaid in Arizona

Warm weather year-round and lower cost of living are attracting more and more seniors to Arizona. To meet the rising demands of this population, Arizona has many senior living options available, including high-quality assisted living communities, and the average monthly costs of assisted living in Arizona are lower than the national average. 

Arizona’s Medicaid program is called the Arizona Health Care Cost Containment System, or AHCCCS. AHCCCS (pronounced “access”) has programs that serve several different groups of Arizona residents, including caretaker relatives, pregnant women, young adults transitioning out of foster care, individuals with a developmental or physical disability, children, and seniors over the age of 65.

For seniors over 65 who require additional medical care, such as assistance with activities of daily living, AHCCCS provides health insurance known as the Arizona Long Term Care Services (ALTCS). Unlike Medicaid programs in some other states, ALTCS (pronounced “All-Tecs”) is a managed care model rather than a waiver system. As such, the state does not cap enrollment in the program. Anyone who meets the eligibility requirements can receive services when their application is accepted. Once a candidate’s ALTCS application is accepted, an assigned case worker helps determine the type of long-term care needed and the appropriate plan and benefits.

Some of the basic eligibility requirements for ALTCS include that the applicant have a social security number or apply for one, as well as be a U.S. citizen and Arizona resident aged 65 or over or who is blind or disabled. Certain income limits also apply. In addition, applicants must:

  • Require a certain level of care or assistance, as determined by AHCCCS
  • Live in an AHCCCS-approved living arrangement (e.g., assisted living community, nursing facility, or in-home care)
  • Apply for all available cash benefits, including Veterans’ Assistance benefits, unemployment, social security, etc.

Although ALTCS does not cover room and board because it is considered health insurance, an individual can use it to cover some medical costs associated with assisted living, such as dental care, medication management, nursing care, medical supplies, diagnostic exams, and preventative check-ups. 

Long-Term Care Insurance

Most medical insurance policies do not cover long-term care that you might receive in an assisted living community. However, you can purchase separate long-term care insurance policies that cover at least some of those costs. 

For instance, some long-term care insurance covers:

  • Assistance with activities of daily living
  • Skilled nursing care
  • Therapy such as occupational, physical, speech, or rehabilitative
  • Dementia care

Check with your insurance agent to see what is covered if you already have a policy. It’s important to note that you would need this type of insurance before moving into assisted living, or you would likely be denied coverage. If you don’t yet have a policy but would like to learn more, the American Association of Long-Term Care Insurance is a helpful resource as you research this option.

Veterans’ Benefits 

Veterans and their spouses might have access to another source of funding for assisted living through the Department of Veterans Affairs (VA). The VA offers a tax-free benefit called the Aid and Attendance Benefit to offset long-term care costs in assisted living communities. Veterans and their spouses who require assistance with at least two activities of daily living are eligible to apply. Contact American Veterans Aid for a free consultation with one of their benefits consultants.

Private Pay and Assets

In addition to Medicaid, long-term care insurance, and VA benefits, many seniors also use a combination of personal savings, private life insurance, retirement savings and pensions, and home equity to pay for assisted living. It can be helpful to talk to a professional like a financial advisor, insurance agent, or attorney specializing in elder care. 

Exceptional Senior Living Should Be Affordable

At Solterra Senior Living, we believe that the cost of assisted living should not be a deterrent to having the life you want and deserve. We work with families daily to help them find the best financial solutions, including paying for assisted living with Medicaid, VA benefits, personal funds, and more. Wherever you are in the process of exploring assisted living financial assistance, feel free to contact us to ask questions, take a tour of one of our beautiful communities, and find out more about how assisted living helps seniors live well.