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Planning Ahead: Medicaid’s Role in Ensuring Quality Senior Care

Planning Ahead: Medicaid’s Role in Ensuring Quality Senior Care

It’s easy to get caught up in the busyness of today and put off planning for the future. If you’re caring for an aging loved one, planning ahead is one of the best things you can do to ensure continued high quality of life and care for them, even if their health needs change. Having a detailed plan in place before it’s needed and including your loved one in the planning process can help ease transitions later. 

For seniors diagnosed with dementia or who might benefit from assistance with activities of daily living in the future, it is essential to understand the long-term care options that are available to them. Assisted living, respite care, and memory care provide essential services to support seniors and their families. Some communities, like The Mission at Agua Fria Senior Living, have these options in the same place, so you never have to worry about moving if your needs change. 

Although the costs for long-term care might seem daunting, many families can cover the expenses with a combination of financial resources, including Medicaid. To pay for residential long-term care like memory care or assisted living with Medicaid, you must ensure the community you choose is Medicaid-certified. 

Choosing a Medicaid-certified community like The Mission at Agua Fria has the added bonus of giving you peace of mind that your loved one will receive high-quality care since the community must meet specific state requirements for certification.

Long-Term Senior Care Options

When it comes to senior care, you want the best for your loved one. Fortunately, with the many advances in science, technology, and health care, people are living longer, fuller lives than ever before. As a result, excellent long-term care options that focus on maintaining independence and holistic health are plentiful. Depending on your family’s needs, you might consider the following types of long-term care:

  1. Independent Living – For seniors looking for an easier, maintenance-free lifestyle and who don’t require regular medical care or assistance with activities of daily living, there are a range of residential options. Independent living apartments, condos, townhomes, and small homes are available to rent or buy. These communities also sometimes offer shared, resort-like amenities. Smaller living spaces means they are easier to maintain, and many seniors enjoy joining a tight-knit community with others who are in a similar stage of life. 
  2. Assisted Living – For seniors who need some assistance with activities of daily living, assisted living communities generally provide 24-hour access to help with things like medication management, bathing, and transportation, among other things. Residents enjoy social activities and dining services as well. 
  3. Memory Care – For seniors diagnosed with Alzheimer’s disease or other forms of dementia or who are living with memory loss, memory care programs provide specialized care in a secure environment. Staff receive additional training in dementia care, and seniors can participate in cognitive rehabilitation and social activities. 
  4. Respite Care – For families looking for short-term, temporary care, respite care is a wonderful choice. Caregivers who need to take time away for rest or other obligations have peace of mind that their loved ones are receiving a high level of care from trained professionals. The seniors can enjoy all the same amenities, services, and social activities as the other residents. 

Paying for Long-Term Care With Medicaid

Once you’ve decided on the best long-term care options for your family, the next step is figuring out how to pay for it. Medicaid can help! As a national program, Medicaid helps provide health coverage for millions of Americans annually. The federal government and the states work together to fund it, and every state is responsible for administering the program for its residents. 

Medicaid requirements and benefits vary a bit from state to state. For instance, Arizona’s Medicaid program is known as the Arizona Health Care Cost Containment System (AHCCCS). Within AHCCCS, seniors or disabled Arizona residents who need long-term care can apply for benefits under the Arizona Long Term Care System (ALTCS). Several organizations, like Senior Care Planning and Arizona Medicaid Planning Services, work with families to help them navigate the ALTCS program and ensure they are receiving all the benefits for which they are eligible. 

For seniors and families across all U.S. states, the American Council on Aging provides a free service to help seniors determine eligibility for their state of residence and locate a Medicaid planning professional near them.  

Eligibility Requirements for Medicaid

Generally speaking, to be eligible for Medicaid long-term care benefits, an applicant should be:

  • A resident of the state in which they are applying for benefits
  • Age 65 or older or permanently disabled or blind
  • Under the state-set income level
  • In need of long-term care, according to the state’s definition

If your loved one is eligible for Medicaid, you should enroll them as soon as possible, even if they’re not ready for assisted living yet. The enrollment process can be lengthy, so starting sooner rather than later is a great idea.

Long-Term Care Services Covered by Medicaid

Since Medicaid is a form of health insurance, it does not cover room and board. In addition, Medicaid cannot be used to pay for independent living options. 

When it comes to assisted living and memory care communities, though certain medical care and other services are often eligible for coverage, including:

  • Therapies including physical, occupational, and speech
  • Assistance with the coordination of care
  • Attendant care, or personal care, services like assistance with activities of daily living (e.g., bathing, toileting, transferring, etc.)
  • Dental care or services of up to $1,000 each year
  • Help with managing medications
  • Doctor visits, including diagnostic exams and check-ups
  • Specific medical equipment, medical supplies, and specialized furniture that might be necessary for assistance with activities of daily living
  • Transportation assistance specifically for medical care
  • Behavioral health care (e.g., cognitive rehabilitation in memory care communities, education related to health and living skills, including issues related to medication management, etc.)
  • Some support services like respite care, family support, and personal assistance

Some states use a waiver system that allows them more flexibility in what services can be covered by Medicaid. When you enroll in Medicaid, you will be assigned a case manager who can help you understand all the requirements and benefits in your state program. Be sure to discuss your situation with your case manager, letting them know all the health and medical services you need to see if anything else could be covered and to ensure you receive all possible benefits.

Live Well at The Mission at Agua Fria

If you’re interested in the highest quality senior care for your loved one, we would love for you to explore what the Mission at Agua Fria is about. Whether you’re considering assisted living, memory care, or respite care, our community has the amenities and services to inspire the fulfilling lifestyle and independence that your loved one wants. Since we are Medicaid-certified, your family can cover many of the costs of respite care, memory care, and assisted living with Medicaid.Contact us today to schedule a tour and learn more about how we empower our residents to live their best lives and what we can do for you and your family!