Does Medicaid Pay for Memory Care?

The short answer to this question is “NO.” But, the situation is complicated, very complicated.

We receive many calls asking us to help seniors obtain Medicaid benefits for “memory care.” There is a lot of confusion about “memory care.”

First, the only facilities I have seen call their services “memory care” are assisted living facilities. Assisted living facilities are different from nursing homes (also known as “skilled nursing facilities”).

Many clients call and say that the “memory care facility” they would like for their loved one “takes Medicaid.” This is so misleading that I wonder if the facility is trying to mislead people. Here are the problems with an Assisted Living Facility/Memory Care “accepting Medicaid”:

1. There are limited Medicaid benefits available in Florida for people who reside in an assisted living facility. However, they are limited – Medicaid will pay only for the care portion of assisted living/memory care expenses. This amount varies but is usually $1,200 – $1,500 per month. Medicaid does not pay the room and board portion of assisted living/memory care expenses.According to Genworth, a large long term care insurance provider, the average cost of assisted living room and board in Florida is $4,000.If your loved one can afford to pay $4,000 per month from their own income, then read on. If not, you probably should conclude that Medicaid will not help your loved one live in memory care.
2. There is a waiting list for Medicaid benefits in assisted living/memory care. Florida Medicaid does not publish how many people are on the waiting list, and it does not disclose how long a person may end up waiting to receive these benefits. The wait could, and probably will be, years.People with the greatest needs are placed near the top of the waiting list.People who have been residing in a nursing home (even for “rehab”) for 60 days go to the top of the waiting list. Thus, people who have been residing in a nursing home can transition to assisted living/memory care with Medicaid, so long as the person can pay the room and board expenses for assisted living/memory care.
3. Remember – to receive Medicaid benefits in assisted living/memory care, the person must qualify for Medicaid. At this time, January 2024, they must have less than $2,829 in income per month and less than $2,000 in assets. If the person desiring memory care assistance has greater income or greater assets, an elder law attorney, such as Blackburn Law Firm, PLLC, can help restructure income and assets in order to qualify. This is even more complicated than figuring out the difference between assisted living, memory care, and nursing home care. However, don’t give up. Elder law attorneys can almost always find a way to help someone qualify.
4. Medicaid will pay for nursing home/skilled nursing facility care, all of it.

It has been my experience that assisted living/memory care staff do not explain the limitations of Medicaid benefits in assisted living/memory care. I hope that this brief explanation helps you help your loved one.

If Blackburn Law Firm, PLLC/LifePlanLaw.com can help further, please call us at 727-826-0923 to schedule a complimentary consultation.