Long-Term Care Coverage Through Medicare
Part 4, Chapter 14: Specialized Situations: Coverage for Long-Term Care Page 4
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However, many decisions regarding the types of services that are covered by Medicaid are made on the state level rather than on the federal level. Thus, the services that are available to Medicaid recipients differ significantly from state to state. For example, as we discussed earlier, the Medicaid programs in a number of states have received federal waivers that allow for coverage for some types of long-term care for eligible Medicaid recipients in an assisted living facility rather than in a nursing home.
Assisted living facilities may offer a wide range of services, depending on individual needs and on the particular program. Assisted living generally involves moving to a special apartment complex or residence. Depending on the situation, available services may include recreation programs, meals, housekeeping, medical and nursing services, and emergency services. Some individuals may need only minor supportive services, such as housekeeping and meals, while others may need the entire range of services, including medical and nursing care.
The availability of coverage for some types of care at an assisted living facility may offer an additional range of choices for senior citizens who require a more supportive program of long-term care than they can obtain at home, but who do not require nursing home care.
Those choices, though, are only available in states that have obtained the appropriate federal waivers. In addition, the programs may differ significantly in each state. Check with your state Medicaid office to determine whether your state has received a waiver related to coverage for assisted living facilities.
In all cases, Medicaid eligibility is dependent on meeting certain qualifications in regard to income and assets. Those eligibility requirements are set on the state level. Thus, the requirements may differ from state to state.
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