Memory Care in Assisted Living: Any advice for someone with Low Income?

Medicaid when it comes to long term placement has funding dedicated to each state for care in a skilled nursing care facility aka a NH. An applicant needs to be “at need” both medically and financially to be eligible. LTC Medicaid pays for the room&board and their medical costs, like fee for the medical director visits, physical therapy’s gait training, get paid by Medicare as the primary insurer and Medicaid as the secondary insurer for how it’s set up in most states.

What has happened as many do not need skilled care, is states get waivers to shift some of the NH $ to pay for others programs, like for PACE day program centers, or for AL or for MC. You have to find out exactly what waivers are out there specifically in your state and then if your mom will fit the eligibility and if there is a facility with an participating in the waiver and has an open bed. Maybe wait lists.

if you mom has a caseworker that’s who you ask. If she doesn’t, I’d suggest that you contact the Area on Aging to see what info they have on waiver programs in your area.

if she is not quite needing skilled care and there is no waiver that covers room & board in AL or MC, I’d try to find a board and care home for her. Board & care are way way less than a NH or even AL sometimes.

Not every State Medicaid pays for Al or MC. These are usually privately paid. There is no guarentee that an AL or MC will take the Waiver. If they do take Medicaid, it depends how many residents are already receiving it if they will take it. ALs and MC facilities are privately owned. They don't make much profit taking Medicaid.

This is a question for a Medicaid caseworker because each State is different. You could find a nice LTC that excepts Medicaid.

Medicaid is run independently by each state, so they each have their own rules and programs. You will need to ask this question to a Medicaid Planner or and elder law/estate planning attorney for her state.