How to Pay for Assisted Living – Medicaid’s Assisted Living Waiver Program

A recent report was issued that reviewed a number of state’s Medicaid Assisted Living Waiver Program.  These programs provide Medicaid funding to assisted living or in-home care. The report found that providing public benefits to eligible individuals before they required skilled nursing care reduced the state’s overall Medicaid expenditures. Further, it provided options to individuals to receive care at home longer than they would have been able to under traditional Medicaid programs. Sounds like a win-win for individuals and states.

A factsheet was published by graduate students at UC Berkeley for the California Advocates for Nursing Home Reform. 

For many states, including Texas, resources through Medicaid waiver programs are very limited.  So much so, that long term care advocates rarely promote these programs as realistic options.  Hopefully, states will adopt the long view promoted by this report and consider expanding public programs to provide care to individuals before they require skilled nursing.

In the meantime, families are left to decide who to provide care to a family member who cannot take care of themselves.  Here are a list of common options:

Family Caregiver

Family members will take on the role of caregiver – whether they are qualified (i.e. physically able) or not.  This level of care is free, so long as you are not counting the toll taken on the caregiver.  Often times a caregiver gives up much more than their time.

In-Home or Respite Care

For most people, aging at home is a preferred option.  The cost to provide this care strains a family’s budget.  Even short term care to give the family member a break may be too much for the family to bear.

Assisted Living/Group Homes

These community can address an individuals needs 24/7 which provides families with peace of mind.  Their cost is typically much less than in-home care and can provide a number of added benefits.  For example, medical professionals are staffed at these communities, residents socialize with each other, and organized activities and outing may improve the quality of life for individuals who were not able to get out much from their home.

So until waiver programs expand, families will be looking for way to fund these options beyond their individual means.  Veteran’s aid and attendance benefits can help a veteran or surviving spouse.  A long term care insurance policy will also be able to provide significant benefits for this type of care.

Most importantly it’s important for families to review their financial condition, start a conversation, and map out an initial plan with all the people they expect to be involved.  Please reach out to our office if you’d like to know more about how to get started.

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