PAYING FOR ASSISTED LIVING

What options do I have to pay for assisted living? Can I (or my loved one) afford to pay for assisted living? Paying for assisted living may seem challenging and confusing, we’d like to help you understand what may be available to you.

What are my options?

Waivers

Indiana offers Medicaid Home and Community-Based Services (HCBS) waiver programs that allow qualified individuals who otherwise would require care in a nursing home to remain in their own home, apartment or in an assisted living facility. To get further information about HCBS waiver programs, start with your Area Agency on Aging. Our interactive map shows which communities accept the waiver, those communities can help you determine whether you qualify.

Veteran Benefits

Veterans and surviving unmarried spouses of veterans may qualify for a benefit that helps cover the cost of assisted living. If you think you might qualify, talk with the assisted living community you are considering, they can help you get started or, visit Federal Benefits for Veterans and Dependents or check out the VA’s benefits fact sheets. Also, download ALFA’s Veteran Affairs Tool Kit with information on eligibility requirements.

Senior Living Care Insurance

If you’re thinking ahead and considering Long-Term Care Insurance, check out these resources for advice:

• Center for Long-Term Care Financing
• AARP
• National Association of Insurance Commissioners
• America’s Health Insurance Plans

Private Pay

When you consider assisted living, make sure you understand what is covered in the fees that you pay and then compare those costs to your current living situation. You may find assisted living is more affordable than you thought! And make sure you talk with your financial planner about your options!

• Medicare: Neither Medicare Parts A nor B offer coverage for comprehensive ongoing long-term care. Medicare A (hospital insurance) may cover costs for a semiprivate room, meals, nursing and rehab services, medications, and medical supplies in a skilled nursing facility for the first 100 days after being released from hospitalization for an acute illness or injury. The first 20 days are covered at 80 percent, with the rest of that time period covered at decreasing rates. It never covers a private room nor services in an assisted living residence. Medicare B only offers reimbursement for covered services you receive from a doctor.
• Ask Medicare is designed to support and assist caregivers. Ask Medicare offers a wide range of helpful information for the nearly 66 million Americans who provide help to an aging, seriously ill, or disabled family member or friend. Ask Medicare offers tools that helps caregivers and those they care for make informed health decisions.
• Medicaid: Medicaid, which provides federal health-care assistance to low-income Americans, is the biggest payer for room, board, nursing care, and social activities in nursing homes. Many, but not all, states now cover some assisted living services under their Medicaid programs; however, these fluctuate widely in terms of eligibility requirements, and dollar amounts of coverage. The Senior Assisted Housing Waiver provides eligible low-income adults a choice of receiving senior living care services in a community-based setting rather than in a nursing facility. Bear in mind that faced with budget deficits for years to come, states are more likely to cut, rather than expand, these programs.
• Housing and Veterans Subsidies: Seniors with annual incomes under $12,000 may qualify for U.S. Department of Housing and Urban Development 202 and Section 8 senior housing, which provide rent subsidies that can help pay for the room-and-board portion of both independent living and assisted living environments. The Department of Veterans Affairs also provides some skilled and intermediate-level care to veterans in its own residences, depending on space availability.

For more information on benefits, visit Federal Benefits for Veterans and Dependents or check out the VA’s benefits fact sheets.