anonymous14092 Asked December 2009

Will Medicaid pay for my mother to go to an Assisted Living facility?

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EXPERT Ralph Robbins Dec 2009
As mentioned, it depends on the state in which you live. Many states have what are known as Medicaid waiver services. This means the state has gone to the feds with a plan to use Medicaid dollars in different ways. Sometimes these waiver services include nursing home long-term care diversion programs.

These programs are generically known as Home and Community Based Services and are intended to help those who would otherwise be eligible for nursing home benefits receive care in less intensive and therefore, hopefully, less expensive, venues.

So, for instance, here in Florida we have nursing home long-term care diversion program. It is managed by private companies that receive a monthly fee (called a "capitation") from the state to offer a continuum of long-term care services to those eligible for both Medicare and Medicaid ("dual eligibles").

Services may be provided in the home, in an assisted living facility, or a nursing home. Most diversion programs will pay approximately $1,000 towards the cost of an assisted living facility.

To participate in long-term care diversion the applicant must meet the same Medicaid requirements as for institutional care; both medical an financial.

Was dad or mom a veteran? If so, you may be looking at another $1,000 + per month towards assisted living via the non-service connected disability benefit known as "Aid and Attendance".
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KelleyBean Dec 2009
I'm not sure about ALL states, but there are many factors to medicaid paying. If your parent receives lets say SSI, most of that is put towards the care and medicaid takes care of the rest. I know that if your mom owns any property, medicaid makes you sell that to put towards the care also. So, pretty much, your mom puts in as much as possible then medicaid picks up the rest. That's how it's done here in VA, but each state has it's own medicaid rules.
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hapfra Dec 2009
Medicaid payments for assisted living depends upon the rules and regs of each state-and also upon the facility itself. If you have a facility in mind, you might want to check with them to see how Medicaid payments are accepted. It may also depend on weather it operates as a 'for profit'-or 'not for profit' type of facility-

As you may see-there are many variables to be considered.

Hap!
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annesmom Jan 2010
My Mom had dementia, we have cared for her for a year sharing days off, between my sister and I. We moved her into an assited living, it lasted one month. they called us to come get her at 1 am. she had a 'sundowners'episode. We want to apply for medicaid, we need assitance for her living expenses. she only gets 2000. an month. we are finding out homes are running 3500- and up. any ideas? help in michigan!
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Hello annesmom. This happened to my husband's dad. He became a handful for his ALF as well, and a danger to himself alone. We had to take him to ER and obtain emergency guardianship to have him admitted to a nursing home. Since he had Vascular Dementia, and was hallucinating and wandering, and due to other factors, we could not care for him in our home. He is a Veteran on Assistance and also on Medicaid.

My own dad was hospitalized, due to behavioral issues (through ER and several "episodes") and they placed him in a Nursing Home. Again, we could NOT care for him in our home, either. So, you may want to talk to your mom's physician, and Social Services to obtain the help you need. A social worker at a facility can give you applications for financial assistance. Best wishes!

PS Where at in Michigan? (We're in the Northern part of lower.)
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NANCE Jan 2010
I'm learning about sundowners now, the nursing home has told me that is what Mom is going through.
The change from sweet to horrid is just leaving me so on edge, I'm so afraid of "whats next".
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The what next depends on the individual. We've encountered a lot of differing changes. Not pleasant, but Support Groups and this site's encouragement helps. You can call the Alzheimer's Association for info or Google sundowners, too. The more you learn the easier you can cope.
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