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What Types of Senior Living Can Be Covered By Medicaid?

What Types of Senior Living Can Be Covered By Medicaid?

Once you decide on the type of long-term medical care that will improve your loved one’s quality of living, the next question is how much it will cost. You will also probably wonder what is covered by certain kinds of insurance.

When your loved one is considering moving to a senior living community, will the costs be covered by Medicaid? What is covered and what is not? Read on below to find out.

What General Types of Senior Living Can Be Covered By Medicaid?

While exact coverage varies from state to state, there are some general types of senior living that Medicaid will help with. For example, Medicaid will cover assisted living for seniors, including memory care services. Usually, skilled nursing and emergency care are also types of senior living costs covered by Medicaid.

What Parts of Senior Living Aren’t Covered By Medicaid?

In most cases, Medicaid does not cover room and board costs for an assisted living community. Therefore, room and board for assisted living apartments is technically not a medical cost.

However, paying for room and board can sometimes be only half the total cost of senior living. Thankfully, there may be other forms of financial assistance that can help cover these costs.

How Is It Determined How Much Medicaid Pays for Senior Living?

Again, the exact coverage of senior living varies by the state where your loved one resides. Each state will have its own Medicaid program with its own rules and guidelines.

In addition to location, another factor determining how much Medicaid pays is the level of care required. A needs assessment will likely determine the level of care needed for a specific senior to determine how many hours of senior living care will be covered by Medicaid. The more care the assessment determines is required, the more hours are covered.

Medicaid in Arizona

The types of senior living that Medicaid can cover also depend on the state where your loved one lives. Arizona’s Medicaid program is part of AHCCCS (Arizona Health Care Cost Containment System). They can apply if your loved one still needs to get this coverage. In addition, the AHCCCS includes coverage known as ALTCS for Arizona long-term care provided to seniors and disabled individuals who need it.

ALTCS programs can provide Medicaid senior living coverage for nursing homes and assisted living. It can also cover home health services and rehabilitation/respite care.

How Seniors Receive Medicaid Coverage

Seniors 65 years or older can apply for ALTCS. They can use the application form and caretaker relatives. The applicant does not need to be in a nursing home or assisted living to qualify. Those who qualify will have no monthly premium.

Which Seniors Can Qualify?

It’s important to note the eligibility requirements before applying so you can be prepared.

In general, seniors may qualify for Medicaid if they have low income or the cost of care exceeds their income. However, there is an income cap for qualification, and the exact amount is subject to change. The income cap also includes certain limits on assets to qualify.

Additional qualifications include the senior being a United States citizen or a qualified immigrant. A person who does not meet these criteria may still be able to get coverage for emergency services. The senior applicant should also be a resident of the state they are applying for Medicaid benefits.

Another requirement is the application must have a Social Security number or be in the process of applying to receive one. If a senior is applying for a Social Security number, they should include the paperwork and forms with their Medicaid application.

Once qualification is approved, or if the senior has this medical coverage already, program contractors and case managers will work to determine what types of senior living care services are covered by Medicaid.

How Is It Determined What Care Is Covered for Qualifying Seniors?

The Arizona Medicaid program will work with other professionals to determine what eligible services are covered, including an ALTCS program contractor working with providers like doctors and assisted living, pharmacies, specialists, and hospitals. In addition, a case manager will also be assigned to seniors to determine specific care.

If a senior qualifies, they can receive Medicaid coverage for the following types of care:

  • Assisted living
  • Home health services
  • Nursing homes
  • Meal delivery programs
  • A certain amount for dental services (typically up to $1000/year)
  • Behavioral health services
  • Case management
  • Medical equipment and supplies
  • Respite care
  • Doctor’s appointments and transportation to these appointments, if needed
  • Emergency response services

What Types of Senior Living Care Covered By Medicaid in Assisted Living?

Again, the exact types of care can vary by state and program. But if Medicaid covers assisted living, some of the services provided include:

Day-to-day personal care services:
These will vary depending on individual needs. But this type of care includes assistance with bathing, dressing, using the toilet, eating, drinking, and other hygiene.

Medical care services:
Services include medication management, physician appointments, specialists, and emergency response.

Home services:
To ensure seniors aren’t over-exerting themselves, assisted living provides help with housekeeping services, including laundry, cleaning, providing essentials like groceries, and providing a meal plan.

BridgeWater Senior Living has multiple senior living community locations throughout Arizona and stands out from other senior living care by accepting Medicaid and offering affordable care and living. Likewise, BridgeWater offers financial assistance and resources.

You can find more information on BridgeWater Senior Living by visiting our website. You can easily schedule a tour on our website for one of our beautiful Arizona communities. If you have any more questions about insurance, our community and amenities, or moving into our assisted living community, don’t hesitate to reach out. Our affordable quality community could be the perfect fit for your loved one!