Can Medicare or Medicaid Help Pay for Assisted Living? Is Other Assistance Available?
“How am I going to pay for assisted living?” This is one of the most common questions seniors ask when they realize they require some kind of assistance to lead happy and autonomous lives.
Assisted living can be expensive, although here at St. Dominic Village we provide outstanding assisted living services for the lowest possible prices.
People considering assisted living are required to pay for it through their savings and personal funds such as pensions and Social Security benefits. Very often, family members contribute to their relatives’ financial needs.
In addition, there are some programs for financial help provided by state and federal funds. Depending on the state you live in, you may have several options and waivers that can partly offset the cost of assisted living.
Here in Texas, the state has instituted the Star+Plus program, which funds assisted living either in residential communities or at home. Seniors with low incomes and limited funds are eligible.
Does Medicare Help with Assisted Living?
Medicare does not normally cover assisted living. Medicare only pays for assisted living after serious injury or surgery. In such cases, Medicare pays for up to 100 days of long-term care at an assisted living facility. The goal is to help people recover with the help of professionals and nursing care.
Once the recovery period is over, Medicare withdraws financial support. Any time exceeding 100 days is paid by the patient from their personal funds.
Does Medicaid Help with Assisted Living?
Unlike Medicare, Medicaid does help with assisted living, although the services the program covers vary between the various states.
Medicaid covers nursing costs, personal care services, and meal preparation services—but not the purchase of the ingredients. In some states, Medicaid pays for transportation as well. Room and board are not covered by Medicaid and must be covered by the person through personal funds and savings.
Some states have put caps on how much assisted living communities can charge for these services. A few states have separate programs that make up for part of the cost of room and boarding.
What Is the Star+Plus Program in Texas?
Texas has designed the Star+Plus program. This is a Medicaid managed-care program for adults with disabilities or who are over 65. Star+Plus offers financial support for those interested in assisted living either in assisted living communities or at home. Seniors who qualify must have low income while the program also sets limits on the amount of assets a senior can have to qualify for financial assistance.
What Does Star+Plus Cover?
The Star+Plus program in Texas covers medical and non-medical care services, including home modifications if you choose to stay at your home. It also covers adult day care, either at home or in an assisted living community.
Specifically, the Star+Plus program pays for the following:
- Medical and non-medical long-term care.
- Adult care. If you choose at-home care, adult care can be provided by a relative—but not your spouse—and the program will pay that person.
- Assisted living.
- Nursing services.
- Home modifications to make your home more suitable for your physical and health circumstances.
- Help with basic daily activities.
- Primary home care.
- Emergency response services.
- Respite care to help your daily caregivers take a break.
- Physical and speech therapy, depending on your needs.
- Personal emergency response services.
Financial Requirements to Qualify for Star+Plus
To qualify for financial support, seniors must prove they have limited resources. The state has set the limits as follows:
- $2,523 monthly income or $30,276 annually (as of 2022).
- Home equity of less than $636,000.
- Savings, retirement funds, and investments of up to $137,400.
Once your application has been reviewed and accepted, you can enroll in the program.
Not all assisted living communities accept Star+Plus, so inquire about it before you choose an assisted living facility.
How St. Dominic Village Helps
Assisted living communities are more affordable than nursing homes, which is a significant reason why states choose to support them.
St. Dominic Village is an assisted living community that serves and cares for a community of elder citizens. Many of the residents outlive their resources, so we heavily subsidize Medicaid residents. To do this, the Village has to raise funds and depend upon the generosity of those who support our mission of Caring for Our Elders with the Compassion of Christ and those who can no longer care for themselves. Call us at 713-741-8701 to find out more about the Village and our service to the community.