I am not in this situation but I think others might be or will soon.
It is my understanding that independent and assisted living are private pay, only. I am not sure LTC policies pay for either.
there are buy in CCRC where a significant buy in is required as well as a monthly nut. Private pay also.
I see some discussions about AL memory care. Some parts of the country have those, some don't.
Where I am confused is when Medicaid comes in. It was my understanding that Medicaid only pays for NH or MC, or home based services , but not AL, because Medicaid doesn't pay for room and board unless there is a medical need like memory care or nursing home care?
Is this different by state?
I hope my question is clear.
ILs are private pay. In NJ ALs are private pay. But if you have paid at least two years and money runs out you may get Medicaid to pay only if the AL hasn't already used the % of medicaid rooms they allow for other residents.
LTC Medicaid will pay for if person meets criteria which means they have no money and what income they have doesn't go over the cap they allow.
Each state is different when it comes to the cap.
And in addition to that escalation, the monthly increases!
If their income goes over the cap then that is just an increased SOC through a Miller or Qualified Income Trust. Or that is my understanding.