Financial Support Options
Long-term care can be expensive, and cost is one the main challenges to overcome. Although some families are able to pay out of pocket for residential and care expenses, many are not able to afford it on their own. For those individuals, there are financial support options including Medicare, Medicaid, Social Security and HUD programs.
Medicaid offers health coverage for some low-income families, including the elderly and people with disabilities. You may qualify for Medicaid based on your income and family size.
Although state Medicaid programs vary, residents with Medicaid will have at least some assisted living costs covered in most states. Some states use different terms to refer to assisted living coverage, such as residential care, adult foster care, personal care homes, or supported living. Home health services are one of the mandatory benefits available for those with Medicaid.
Coverage varies depending on the state, and may include medication administration, chores, homemaker services, and recreational activities. Medicaid does not pay for room and board in any state. However, it may cover meal preparation and serving, just not the cost of food itself.
Medicare is a national health insurance program generally available to seniors 65 and older, or younger people with disabilities or permanent kidney failure requiring dialysis or a transplant.
Home health services are typically covered by Medicare for those who are eligible. To become eligible, a doctor must certify that you are homebound, or that you need intermittent skilled nursing care, specific physical therapy, speech-language pathology, or continued occupational therapy services.
Medicare does not cover long term care such as assisted living, 24-hour care, meal deliveries, homemaker services like laundry, or personal care like bathing or dressing.
Social Security offers financial benefits for people who are disabled, or those who are 62 or older. Along with retirement income for seniors, Social Security provides two other means of financial support. The first is Supplemental Security Income (SSI), which is available for people with limited income and assets. The second program provides state-based benefits that can offer financial support for assisted living. This program is either called Optional State Supplements (OSS) or State Supplementary Payments.
People who are financially eligible can get assistance paying for room and board at an assisted living facility using OSS. This is in addition to Social Security Income payments and is paid directly to the community. The amount of OSS given to the resident is based on his or her income and can range from a few dollars to nearly $1,000 per month depending on income and state policies.
Some states cap the amount assisted living communities that accept Medicaid can charge for room and board. This limit is usually equivalent to the federal Social Security Income benefit, or the Social Security Income benefit plus the OSS payment.
The U.S. Department of Housing and Urban Development, commonly known as HUD, offers a number of programs designed to help seniors and disabled individuals with housing expenses. These programs offer rent subsidies, income-based housing, vouchers, and homeownership opportunities.
Programs typically have high demand, and applicants may face long waiting periods of two years or more. If you’re interested in a HUD program, it’s a good idea to start the application process as early as possible.