Medicare for Assisted Living

Costs for assisted living and care homes are at the top of anyone’s research list when investigating potential care options. Knowing what funding you can get from insurance and in terms of Government federal support (i.e. medicare/medicaid) or local support programs is crucial as they can have a direct bearing on what choice you finally decide upon.

To make that decision easier, we have outlined what is available to residents of North Carolina and Raleigh in particular, so that you can see what assistance you can access if you want to find a place at one of our Bright Horizon assisted living facilities.

Assisted Living and Medicare

Currently, Medicare does not pay for assisted living costs. However, it will cover most costs incurred on a medical basis while a senior is living in a care home. That being said, those costs are usually only covered for a certain period of time. So, if your medical requirements need you to undergo several months of rehabilitation and physiotherapy, you need to be sure first how long your Medicare cover will pay for the associated costs.

There are several Medicare Advantage plans that may be slightly different to the generic Medicare Part A and Medicare Part B plans in which seniors in the US are often enrolled in. Those advantage plans are sold by private insurance companies so could well offer some cover for assisted living costs. It will be detailed in your policy.

Government Federal Support for Assisted Living in North Carolina

In comparison to Medicare, Medicaid is different. As a federal and state program that offers free or low-cost health care to those on a low income, Medicaid can cover some of the costs of assisted living. However, it varies on a state-by-state basis. In general, the main Medicaid program does not pay for room and board at assisted living care homes in North Carolina.

However, some people can qualify for some schemes that may help with the costs. There is special assistance (SA) available which will pay for room and board for just under $1200 a month, more if a person suffers with dementia and needs specialized care. Or, you may qualify for SA if your income is below a certain level per month (this amount often changes on an annual basis) and you do not have more than $2000 in savings.

Local Support Programs in Raleigh, North Carolina

When it comes to local support programs in North Carolina and Raleigh, it is a good idea to approach the community department for help. While they may not be able to help you pay for all your care costs within an assisted living facility, they will be able to point you to the most up-to-date schemes in place. For example, initiatives run by Resources for Seniors, Meals on Wheels of Wake County, and day care facilities that may be able to offer respite for loved ones or some home care services.

Additionally, Medicaid sometimes will pay for personal care services if you find that assisted living is not an option for you (for financial or personal reasons). Making use of the waiver programs or other initiatives like those that are open to individuals with developmental disabilities can help reduce the day-to-day costs of necessary care.

Paying for Assisted Living

There is a fine line and balance to be had when looking at costs of care versus being able to afford the level of help you need. Making use of any funding that you are entitled to is a good way to ensure you are able to choose the right care for you and not be restricted by the costs. There are so many different schemes and initiatives run by the local government, and at a federal level, that means you do not always have to pay for your care entirely out of your own pocket.