If you’ve ever tried to find assisted living facilities that accept Medicaid, you know how challenging it is. After all, a national database doesn’t exist for assisted living facilities that accept Medicaid.
Moreover, many states have databases that note which assisted living facilities accept Medicaid, but it’s worth noting a few important points:
- These databases don’t track or publish Medicaid licensure.
- Users often can’t filter results by forms of payment accepted.
- The databases don’t specify — or track — the number of living spaces allocated for assisted living residents opting to pay for care with Medicaid
We’re here to deliver some good news, though. Medicaid can be used to pay for care in an assisted living facility, even if the facility doesn’t accept Medicaid as a form of payment for the facility itself.
Village Walk Senior Living here: we provide memory care and assisted living solutions to people of all different backgrounds and financial needs. We understand what it’s like to look for the right care for a loved one that won’t break the bank — and that’s covered by Medicaid.
In this article, we’ll take a closer look at why finding assisted living facilities that accept Medicaid can be challenging. We’ll also provide helpful information about Medicaid and assisted living for you and your loved ones on the journey ahead.
Join us! Let’s chat about Medicaid and assisted living.
Why finding Medicaid assisted living facilities is so challenging
Some assisted living referral agents provide services to families to help families find assisted living residents. What you may not know is that these organizations receive compensation from assisted living facilities when a new resident moves into the facility.
As such, assisted living residences won’t provide compensation to a referral agent for Medicaid beneficiaries.
The result? Most placement agencies will include a clause on their website asking if people need “public assistance.”
While most placement agencies care about and genuinely want to help people find the right care for their needs, unfortunately, the contact information provided to these facilities can fall into the wrong hands. As such, people sometimes take advantage of low-income seniors and their families.
If you need help — or consider yourself low-income — when it comes to paying for assisted living, having a lengthy phone conversation with a referring agent can be more of a rarity than a common practice.
But in the best case scenario, the assisted living residence and/or placement agency works with the senior and family to provide care services that are within the senior’s financial and Medicaid-related needs.
Key information to help with finding assisted living facilities that accept Medicaid
Families and seniors: before searching for assisted living residences that accept Medicaid, you’ll want to keep in mind four key pieces of information — or news — about Medicaid and assisted living facilities:
- Not so-good news: Medicaid will only cover assisted living care.
- Good news: You’ll have some discretion regarding using Medicaid funding.
- Good news: Many Medicaid programs exist, giving you options.
- Good news: You can become eligible for Medicaid in several ways.
We’ll dive into greater detail about each of these pieces of information in the sections below.
Medicaid only covers assisted living care
That’s right. No room and board or “rent” coverage, alas.
Medicaid beneficiaries are responsible for covering the cost of housing in an assisted living community.
The facts are that a private room in a nursing home costs, on average, $10,025 a month (Statista, 2024) — and care costs are expected to continue to rise in the next 25 years (Statista, 2024).
Given that 50% of the cost of assisted living is allocated to care services and the other 50% to room and board, the good news is that many states and facilities offer different ways to make room and board more affordable.
For example, where we’re located in Patchogue, NY, our state offers waiver programs and the Program of All-Inclusive Care for the Elderly (PACE). Waiver programs and PACE help seniors who may need financial assistance to better afford the cost of care in our assisted living facility.
Seniors and families: if you’re thinking of assisted living, check with your state’s local healthcare organizations, or the Department of Health Care Services (DHCS), for more comprehensive information about Medicaid coverage for assisted living.
You have discretion with how you use your Medicaid funds
With Medicaid, you’ll have options for how funds are disbursed. For example, assisted living residences either have a direct relationship with Medicaid where the Medicaid program pays the residence for care, or Medicaid pays a 3rd-party caregiver to deliver care.
What that means for you is that if you ask most assisted living facilities if they accept Medicaid, they may not always say yes (see the above sections for reasons why).
But, a “no” answer doesn’t mean you can’t have a direct relationship with Medicaid when it comes to your assisted living needs. For example, a caregiver not associated with an assisted living residence can come to the assisted living residence and provide long-term care to a resident.
Thus, Medicaid pays the caregiver — and not the assisted living residence. In other words, Medicaid beneficiaries can choose and hire their own caregiver to come to an assisted living facility.
In short, you’ll have options with how you use Medicaid funds.
Multiple Medicaid programs exist for assisted living
The other bit of great news about Medicaid is that you’re not locked into one Medicaid program. Two different types of Medicaid programs provide financial support for assisted living services.
With that said, each offers different benefits and has different limitations and criteria for eligibility. The two types of programs are:
- Home and Community-Based Services (HCBS) waivers
- Aged, Blind, and Disabled (ABD) Medicaid
HCBS waivers are for individuals using Medicaid for nursing home-related needs. People using the Home and Community-Based Alternatives (HCBA) and Home and Community-Based Services (HCBS) waivers should be aware that due to their popularity, a person can expect to be placed on a long wait list as part of the HCBS waiver enrollment process.
In contrast, with ABD Medicaid programs, people aren’t often placed on a waitlist. If eligibility criteria are met, a person can be enrolled in an ABD Medicaid program, and the program must provide benefits to that person.
You have options for determining eligibility for Medicaid
“Speaking of eligibility criteria, how do you determine eligibility for Medicaid?” You might be wondering.
You can check your eligibility for Medicaid aid by doing any of the following:
- Visit HealthCare.gov or Medicaid.gov
- Read state-specific eligibility criteria
- Read program-specific eligibility criteria for each Medicaid program
- Reach out to your local assisted living facility and/or care provider
Once you’ve equipped yourself with the right information, you can then determine which assisted living facilities that accept Medicaid that you want to explore.
5 Steps for determining assisted living communities that accept Medicaid
Now that you’re armed with knowledge about Medicaid — and which assisted living facilities accept Medicaid — you’re ready to find an assisted living residence that accepts Medicaid.
At Village Walk, we recommend the following streamlined 5-step process for finding the right care provider that takes Medicaid.
- Determine whether you’ll use ABD Medicaid (often termed “Regular” Medicaid) or HCBS waivers.
- Reach out to an assisted living residence that takes either ABD Medicaid or HCBS waivers.
- Create a list of preferred assisted living residences you want to check out.
- Contact the assisted living’s sales and marketing team to learn more about who they are and the types of services they provide.
- Narrow down which assisted living facilities you want to explore, and schedule a visit to tour their community.
Once you’ve scheduled your visit, be prepared with questions. Senior care advisors love sharing about their offerings.
But, your needs are equally important. Don’t hesitate to come with a handy list of questions, so you can determine whether the facility provides the level of care you expect for your specific needs.
Final considerations for finding Medicaid assisted living facilities
When considering the high cost of living in Patchogue, NY, and the Long Island, NY metropolitan area, you might want to consider other ways to pay for assisted living.
Furthermore, New York (and other states across the United States) provide many ways to pay for assisted living including, but not limited to:
- Supplemental Security Income (SSI)
- Optional State Supplement (OSS)
- Social Security Disability Insurance (SSDI)
- Long-term care and life insurance plans
- Private funds
- Retirement savings
- Loans
- Funds from a recently sold home
Whether you choose a skilled nursing facility, an assisted living community, or a memory care neighborhood, know that you have options when funding personal care.
At Village Walk, our compassionate caregivers are in the business of helping you and your loved ones live your best life in comfort and effortless happiness. At a price that won’t break the bank, we offer assisted living care and comprehensive life enrichment programs that meet our residents where they’re at in their life journey.
To learn more about or schedule a visit at our Patchogue, NY-based location, contact us today.
Table: Fast facts about Medicaid and assisted living
| 5 Fast Facts About Medicaid and Assisted Living |
| 1. 30,600: the number of total assisted living and other residential care communities in the United States today (Ahcancal.org, 2024) |
| 2. The Northeast has the fewest number of assisted living communities of the four different regions — Northeast, Midwest, South, and West — in the United States (Ahcancal.org, 2024). |
| 3. Some assisted living communities also offer dementia and subacute rehabilitation programs. |
| 4. Some of the most common conditions an assisted living community helps with are Alzheimer’s disease and dementia. |
| 5. Many assisted living communities offer day trips and life enrichment programs to enhance the mental health and well-being of their residents. |
Did you know?
Did you know that if you or a loved one is a veteran and/or spouse of a veteran, financial assistance may be available to you to help with the cost of assisted care?
We often hold webinars in the local community about how seniors can use Veteran benefits to cover the cost of care. To learn more, check out our Facebook page here.
FAQ about assisted living facilities that accept Medicaid
What types of Medicaid programs can be used at an assisted living facility?
Some of the most common Medicaid programs used are Home and Community-Based Services (HCBS) or Home and Community-Based Alternative (HCBA) waivers. Also, Aged, Blind, and Disabled (ABD) Medicaid can be used.
In short, every state offers different support for assisted living.
Can Medicaid cover skilled nursing and memory care services?
Yes! In some cases, Medicaid can cover medical care services provided in nursing homes and memory care communities.
Eligibility and coverage depend on the facility and state.
What are other ways to pay for assisted living?
Some of the most common ways to pay for assisted living other than with Medicaid include:
- Supplemental Security Income (SSI)
- Optional State Supplement (OSS)
- Social Security Disability Insurance (SSDI)
- Long-term care and life insurance plans
- Private funds
- Retirement savings
- Pensions
- Loans
- Funds from a recently sold home
“They are genuinely invested in the residents’ lives…”
“With the growing number in senior care both assisted as well as memory care, a lot of people are looking for a place to give their family a new home. Look no further!
One of the standout aspects of Village Walk is its dedicated staff. They aren’t just caregivers; they’re invested in residents’ lives.
Village Walk Assisted Living is an excellent choice for seniors seeking a supportive and vibrant community. The combination of compassionate care, engaging activities, and comfortable living arrangements creates an environment where residents can thrive.
I left with a positive impression, confident that Village Walk prioritizes the dignity and happiness of its residents. I highly recommend it to anyone considering assisted living options.” – Anthony S., grateful Village Walk community member.
