Assisted Living and Medicaid

[supersupps]

I was told that Oregon accepts medicare and medicaid for assisted living. Are there other states that also accept medicaid?

 

[Arthur Rudnick]

I can't speak specifically about Oregon, but some states are running trial Medicaid programs to pay for Assisted Living & home care, but those states are few and far between. They need to receive a federal waiver to do so. Generally, Medcaid only pays for nursing homes in a Medicaid approved facilty.

Not sure about Medicare. Medicare will only pay a maximum of 100 days for only skilled care. Normally, ALFs provide custodial care, which Medicare will not pay for. Those that enter ALFs are usually there for a longer period than 100 days.

Once an ALF resident moves from custodial care to skilled care status, they are usually moved from an ALF to a nursing home.

Also, keep in mind that in order to qualify for Medcaid, one has to have minimum assets (usually about $2,000, but this varies by state) and also minimum income levels, which in many states equals about 130% above poverty levels.

You might want to check with Oregon's Medicaid system (CMS) and confirm this. If you find out anything different, please let us know.

 

[TriciaS]

You might also want to look into which (if any) ALF will accept Medicaid. Many that I've talked to say they will remain private pay even if Medicaid starts paying because they are filled with wait lists & don't want to have to accept the low Medicaid payments.

 

[RichJ]

I can't speak specifically about Oregon, but some states are running trial Medicaid programs to pay for Assisted Living & home care, but those states are few and far between. They need to receive a federal waiver to do so. Generally, Medcaid only pays for nursing homes in a Medicaid approved facilty.

Not sure about Medicare. Medicare will only pay a maximum of 100 days for only skilled care. Normally, ALFs provide custodial care, which Medicare will not pay for. Those that enter ALFs are usually there for a longer period than 100 days.

Once an ALF resident moves from custodial care to skilled care status, they are usually moved from an ALF to a nursing home.

Also, keep in mind that in order to qualify for Medcaid, one has to have minimum assets (usually about $2,000, but this varies by state) and also minimum income levels, which in many states equals about 130% above poverty levels.

Massachusetts has something like this. My mother is under a plan where she gets in home services and some additional programs she's eligible for due to being nursing home qualified, including home making and personal care attendant for a few hours a week through MassHealth [medicaid]. It's great for seniors to stay at home and a godsend for caregivers.

God knows I have no desire to bathe my mother.

Also, the 2,000.00 limit is, i believe, a federal guideline for eligability. What is really irritating is the cash value in life insurance counts towards that limit.

 

[Arthur Rudnick]

originally posted by richj

Also, the $2,000.00 limit is, i believe, a federal guideline for eligability. What is really irritating is the cash value in life insurance counts towards that limit.

Although Medicaid is a combination of federal & state rules & regs, the income & asset limits are set by each state. Most states have a $2,000-$3,000 asset limitation (not counting one's home) in order to be eligible. In NY, the limit is $13,800.

The cash value in a life insurance policy is considered a countable asset and must be spent down just like any other asset before qualifying.